Provider Demographics
NPI:1346346061
Name:A TO Z FAMILY CARE PC
Entity Type:Organization
Organization Name:A TO Z FAMILY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:208-733-9697
Mailing Address - Street 1:PO BOX 1537
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-1537
Mailing Address - Country:US
Mailing Address - Phone:208-733-9697
Mailing Address - Fax:208-733-3197
Practice Address - Street 1:2086 ADDISON AVE E
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5306
Practice Address - Country:US
Practice Address - Phone:208-733-9697
Practice Address - Fax:208-733-3197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807194400Medicaid
ID1345676Medicare ID - Type Unspecified