TABLE ROCK MOBILE MEDICINE PLLC is a family nurse practitioner in Meridian, ID. TABLE ROCK MOBILE MEDICINE PLLC NPI is 1194186437. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
3090 E GENTRY WAY STE 210 MERIDIAN, ID ZIP 83642-550 Phone: (986) 224-8420 Fax: (844) 268-7286
The provider's authorized official is Bradley Bigford . The authorized official title is Sole Member and has the following contact phone number (986) 224-8420.
The CLIA number assigned to this NPI record is 13D2113001 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/15/2016 and was last updated on 5/11/2024.
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:
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: 11/21/2025
NPI Synchronization or Removal
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