Individual
ASHLEY CORA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 371-3155
Mailing address
4999 E WOODCARVER DR, BOISE, ID 83716-7148
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
62295
ID
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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