Individual
DR. JESSICA LEA DUVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
325 W IDAHO ST, BOISE, ID 83702-6040
(208) 514-2525
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M14600
ID
208M00000X
Hospitalist Physician
A123788
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2011
Last updated
04/05/2022
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