Individual
MARY PAIGE JEFFRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4750 N FIVE MILE RD, BOISE, ID 83713-2715
(208) 375-0500
(208) 375-4310
Mailing address
2808 S DENALI PL, MERIDIAN, ID 83642-8103
(208) 288-1229
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN00541
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2407007
—
NV
Enumeration date
04/20/2006
Last updated
09/15/2010
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