Individual
JACOB CARLTON GERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
100 E IDAHO ST STE 300, BOISE, ID 83712-6269
(208) 381-7370
Mailing address
305 E JEFFERSON ST, BOISE, ID 83712-6273
(208) 381-7370
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
56882
ID
Other
Enumeration date
09/13/2017
Last updated
07/21/2022
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