Individual
MRS. DOLORES ANNETTE JONATCHICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-1000
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8772
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
693551
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
70600
ID
Other
Enumeration date
03/06/2017
Last updated
02/18/2022
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