Phelps, Paula Brutz

Phelps, Paula Brutz is an individual health care provider with primary practice located at 1151 Hospital Way Suite D, Suite 201, Pocatello ID 83201-5091. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Phelps, Paula Brutz can be contacted via phone (208) 478-2472.

Contact Information

Primary practice address
1151 Hospital Way Suite D, Suite 201 Pocatello ID 83201-5091
Phone: (208) 478-2472
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-166 Idaho

Profile Details

NPI number 1477690899
LBN Legal business name Phelps, Paula Brutz
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Jun 19th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477690899 NPPES
Idaho Other PAJ81 BCS
Idaho MEDICAID 004392500 BCS

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