Individual
FLINT DEAN JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
166 S 5TH ST, MONTPELIER, ID 83254-4959
(208) 847-3847
Mailing address
166 S 5TH ST, MONTPELIER, ID 83254-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73078
ID
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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