Individual
MARCEY LOUISE WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 W FORT ST BLDG 124, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
16357 MANATEE AVE, CALDWELL, ID 83607-5404
(360) 584-2338
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
53784
ID
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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