Individual
JANESSA WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-3131
(208) 367-3174
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
62248
ID
Other
Enumeration date
06/02/2023
Last updated
10/17/2023
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