Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CAROL KLETT VANCE, M.D.
Active Sole ProprietorNeurodevelopmental Disabilities · AMMON, ID
Registration Details
- NPI Number
- 1417012022
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 26, 2006 (19.32140628703 yrs)
- Last Updated
- Mar 5, 2008
- License
-
M9751 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1619 CURLEW DR STE 6AMMON, ID, 834064719Browse ID providers · Browse ZIP 83406
- Phone
- 2085234688
- Fax
- 2085234990
- Primary Specialty
-
Neurodevelopmental Disabilities
2080P0008X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.