Glade Southam is a Family in Rexburg, Idaho. Glade Southam practices all healthcare services and medical treatments related to Family. The NPI Number for Glade Southam is 1588654628. The last update date is 2007-10-01.
Glade Southam's current location address is Byu - Idaho Nursing Department, Rexburg, Idaho. You can contact this provider via phone number 2084961385 and fax number 2084965386. The mailing address for Glade Southam is Byu - Idaho Nursing Department, Rexburg, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Glade Southam |
|---|---|
| Address | Byu - Idaho Nursing Department, Rexburg, Idaho |
| Phone Number | 2084961385 |
| Fax Number | 2084965386 |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1588654628 |
|---|---|
| Provider Enumeration Date | 2005-10-27 |
| Last Updated Date | 2007-10-01 |
Provider Mailing Address Detail
| Address | Byu - Idaho Nursing Department |
|---|---|
| City | Rexburg |
| State | Idaho (ID) |
| Post Code | 834600620 |
| Phone Number | 2084961385 |
| Fax Number | 2084965386 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | NP - 747A |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Post Comment/ Review Below
What is the unique identification code assigned to Glade Southam by the Centers for Medicare & Medicaid Services?
The Glade Southam has been issued the NPI (National Provider Identifier) 1588654628. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Glade Southam?
The Glade Southam is situated at Byu - Idaho Nursing Department, in the city of Rexburg, state of ID, with the zip code 834600620.
What is Glade Southam's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Glade Southam is Family, and the taxonomy classification code that categorizes this area of expertise is 363Lf0000X.
On what date did Glade Southam receive its 1588654628 assignment from the Centers for Medicare & Medicaid Services?
The Glade Southam was assigned its 1588654628 on 2005-10-27, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Glade Southam, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Glade Southam, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-10-01.