Individual
JACLYN R HOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 NW 16TH ST, FRUITLAND, ID 83619-2202
(208) 452-8600
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-0005180
VA
363A00000X
Physician Assistant
Primary
PA-1903
ID
Other
Enumeration date
01/12/2016
Last updated
11/09/2023
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