Individual
COLTON JEFFERY PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, PMHNP-BC
Contact information
Practice address
1675 CURLEW DR, AMMON, ID 83406-4718
(208) 523-5319
Mailing address
PO BOX 2106, IDAHO FALLS, ID 83403-2106
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
58777
ID
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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