Provider Demographics
NPI:1427717842
Name:MOUNTAIN MOBILE MEDICINE, PLLC
Entity type:Organization
Organization Name:MOUNTAIN MOBILE MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:208-484-9468
Mailing Address - Street 1:PO BOX 931
Mailing Address - Street 2:
Mailing Address - City:DONNELLY
Mailing Address - State:ID
Mailing Address - Zip Code:83615-0931
Mailing Address - Country:US
Mailing Address - Phone:208-484-9468
Mailing Address - Fax:
Practice Address - Street 1:186 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DONNELLY
Practice Address - State:ID
Practice Address - Zip Code:83615-7000
Practice Address - Country:US
Practice Address - Phone:208-328-3866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1033641154OtherNPI
1881356087OtherNPI
1023439213OtherNPI