BRYCE WADE ANDERSEN NP-C NPI 1174955306

NPI Information

  • NPI: 1174955306
  • Provider Name: BRYCE WADE ANDERSEN, NP-C
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3385 POTOMAC WAY
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 522-7246

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NPI Details

Bryce Wade Andersen, NP-C is a primary care nurse practitioner in Idaho Falls, ID with 12 years of experience. Bryce Wade Andersen, NP-C NPI is 1174955306. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3385 POTOMAC WAY
IDAHO FALLS, ID
ZIP 83404-978
Phone: (208) 522-7246

The NPI 1174955306 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2013 and was last updated on 3/11/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareNP1303AIDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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