Individual
GRACE MACALL PARISEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8888
Mailing address
1720 S LATAH ST, BOISE, ID 83705-2952
(509) 570-8514
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
73459
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
OR
Enumeration date
07/25/2019
Last updated
05/30/2023
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