Individual
JACOB CRAIG STODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
2455 BLUE CAMAS WAY, IDAHO FALLS, ID 83402-3849
(208) 242-8036
Mailing address
2455 BLUE CAMAS WAY, IDAHO FALLS, ID 83402-3849
(208) 242-8036
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
5381502
ID
Other
Enumeration date
04/04/2026
Last updated
04/04/2026
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