Individual
CRYSTAL LEIGH ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 901-6094
(208) 343-5301
Mailing address
6382 S APEX AVE, MERIDIAN, ID 83642-1060
(208) 901-6094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2671947
ID
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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