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Autumn Grove
NPI 1033596747 · on the registry since 2015
Practice
- Address
- 8238 N Government Way
Hayden, ID 83835 - Phone
- (208) 762-2100
- Fax
- (208) 762-2101
- Clinicians at this address
- 3
Additional practice sites
- 11185 W. 6th Avenue, Lakewood, CO
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Also registered as
- 2251X0800X
- Licence states on file
- CO, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-08-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho