Individual
MRS. CHELSEA ROSE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
9976 W EMERALD ST, BOISE, ID 83704-9769
(208) 229-3742
Mailing address
9976 W EMERALD ST, BOISE, ID 83704-9769
(208) 229-3742
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
57758
ID
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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