Individual
JESSICA INEZ GRATZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-2420
Mailing address
184 W 200 N, JEROME, ID 83338-5232
(208) 539-9348
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
61853
ID
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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