Individual
MRS. MICHELLE G STRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
9850 W ST LUKES DR STE 280, NAMPA, ID 83687-7912
(208) 323-3767
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N-45468
ID
363LA2100X
Acute Care Nurse Practitioner
Primary
NP-1278A
ID
Other
Enumeration date
07/19/2006
Last updated
11/03/2022
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