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Individual

MRS. JEANNIE ANNE ARCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
1421 CLEVELAND BLVD, CALDWELL, ID 83605-3861
(208) 409-8966
Mailing address
1421 CLEVELAND BLVD, CALDWELL, ID 83605-3861
(208) 409-8966

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
55871
ID

Other

Enumeration date
06/21/2017
Last updated
07/21/2022
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