Individual
JADYN SHAY MULLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2537 W STATE ST STE 200, BOISE, ID 83702-2200
(208) 336-0895
Mailing address
1854 E PORTER ST, KUNA, ID 83634-2551
(208) 996-9064
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
ID
Other
Enumeration date
11/01/2025
Last updated
11/01/2025
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