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REBECCA LYNN FAIRBANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1112 W MAIN ST STE 106, BOISE, ID 83702-5137
(208) 949-9904
Mailing address
4722 N TATTENHAM WAY, BOISE, ID 83713-2528
(208) 908-9183

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-38031
ID

Other

Enumeration date
10/21/2022
Last updated
10/21/2022
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