Provider Demographics
NPI:1689621294
Name:APN SOLUTIONS LLC
Entity Type:Organization
Organization Name:APN SOLUTIONS LLC
Other - Org Name:FAMILY CARE CLINIC OF IDAHO FALLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:FNPC
Authorized Official - Phone:208-523-3436
Mailing Address - Street 1:2450 E 25TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7577
Mailing Address - Country:US
Mailing Address - Phone:208-523-3436
Mailing Address - Fax:208-523-2303
Practice Address - Street 1:2450 E 25TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7577
Practice Address - Country:US
Practice Address - Phone:208-523-3436
Practice Address - Fax:208-523-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP616A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP99441Medicare UPIN