Individual
MRS. BRIANNA ASHLEY CRACOLICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1510 12TH AVE RD, NAMPA, ID 83686-6008
(208) 302-6800
(208) 302-6855
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
53580
ID
363LP2300X
Primary Care Nurse Practitioner
Primary
NP-53580
ID
Other
Enumeration date
12/05/2018
Last updated
02/27/2024
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