OrganizationActive
Olde Town Medical
NPI 1245690544 · Adult Health Nurse Practitioner · Meridian, ID
Provider details
- NPI number
- 1245690544
- Entity type
- Organization
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Susan Tomey, Provider/Owner(208) 888-5422
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
124 E Pine Ave
Meridian, ID 83642-2331
Phone: (208) 887-5422
Fax: (208) 888-6297
Approximate (ZIP-level) locationGet directions
Mailing address
124 E Pine Ave
Meridian, ID 83642-2331
Registry dates
- Enumerated
- 2016-02-29
- Last updated
- 2016-03-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.