Individual
ALLISON PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
120 E MALLARD DR APT 303, BOISE, ID 83706-3989
(817) 845-1011
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9062
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P9062
IDAHO STATE BOARD OF PHARMACY
ID
Enumeration date
12/01/2020
Last updated
12/01/2020
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