Individual
DR. JESSICA N WASIELEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2130
(208) 322-1731
Mailing address
2963 E COPPER POINT DR, SUITE 150, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-1731
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
EC-05-030
ME
207P00000X
Emergency Medicine Physician
Primary
M-10203
ID
207P00000X
Emergency Medicine Physician
MD183358
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808037300
—
ID
Enumeration date
12/01/2006
Last updated
03/18/2022
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