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Individual

JULIE VANTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
960 S BROADWAY AVE # 505, BOISE, ID 83706-3600
(208) 780-6299
Mailing address
5485 N COLLISTER DR, BOISE, ID 83703-3809
(208) 867-1727

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
ID-N27581
ID

Other

Enumeration date
12/28/2016
Last updated
12/28/2016
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