Individual
JEREMIAH W NEIBLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
228 SHOUP AVE W, TWIN FALLS, ID 83301-5022
(208) 814-9100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-1504A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154723120
—
ID
Enumeration date
09/22/2014
Last updated
01/09/2015
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