Individual
JORDYN MORICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2235
(208) 381-4556
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1205270
—
363A00000X
Physician Assistant
Primary
6161875
ID
Other
Enumeration date
02/14/2023
Last updated
02/24/2025
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