Individual
NICOLE C PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
1740 E 17TH ST, SUITE C, IDAHO FALLS, ID 83404-6375
(208) 524-1278
Mailing address
5884 GLENEAGLES DR, IDAHO FALLS, ID 83401-6336
(208) 403-7221
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/17/2009
Last updated
04/22/2020
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