Individual
NANCY JANE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
341 W WASHINGTON ST, BOISE, ID 83702-5943
(208) 334-3220
(208) 334-2963
Mailing address
341 W WASHINGTON ST, BOISE, ID 83702-5943
(208) 334-3220
(208) 334-2963
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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