Individual
MRS. ELIZABETH MACHELLE MIGNEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
6750 W DIAMOND ST, BOISE, ID 83709-4933
(208) 447-7411
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-33360
ID
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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