Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 04568 | KY |
Y | 207RR0500X | Rheumatology | O1534 | ID |
NPI | 1083063366 |
---|---|
Provider Name | Elise Danielle Mcveigh |
First Address | Coeur D Alene, ID 83814-6051 |
Second Address | Coeur D Alene, ID 83814-4400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 28/07/2021 |