Individual
JESSICA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
75622
ID
163WN0002X
Neonatal Intensive Care Registered Nurse
RN105745
AZ
363LN0000X
Neonatal Nurse Practitioner
Primary
75622
ID
Other
Enumeration date
01/16/2023
Last updated
04/25/2023
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