Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Table Rock Mobile Medicine PLLC

Organization Family Nurse Practitioner · NPI 1194186437

Table Rock Mobile Medicine PLLC is a Family Nurse Practitioner in Meridian, Idaho. Licensed in Idaho. Registered with an NPI since 2016.

Licensed in
ID
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3090 E Gentry Way Ste 210
Meridian, ID 83642-3550
Phone: (986) 224-8420
Fax: (844) 268-7286
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP-1252A (ID)

Record details

NPI number1194186437
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bradley Bigford — Sole Member · (986) 224-8420
NPI enumeratedMarch 15, 2016
Last updated in NPPESMay 11, 2024
Certification dateMay 11, 2024
Mailing addressPo Box 44953, Boise, ID 83711-0953

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