Individual
MELANIE EILEEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9850 ST LUKES DR, NAMPA, ID 83687-7912
(208) 505-2050
Mailing address
4697 N ANCHOR WAY, BOISE, ID 83703-3170
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
43954
ID
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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