Individual
JENNIFER NETHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
417 S 6TH ST, BOISE, ID 83702-7632
(208) 577-4400
Mailing address
5659 N MORPHEUS PL, MERIDIAN, ID 83646-5981
(208) 391-9413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
59193
ID
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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