Individual
MR. STANLEY MCDOWELL HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
190 E BANNOCK ST., BOISE, ID 83712
(208) 381-6129
Mailing address
190 E BANNOCK ST., BOISE, ID 83712
(208) 381-6129
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-412A
ID
Other
Enumeration date
03/17/2006
Last updated
08/04/2011
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