Individual
JARED WILLIAM RICKABAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
2375 E SUNNYSIDE RD STE J, IDAHO FALLS, ID 83404-8281
(208) 542-7060
Mailing address
1551 N 700 E, SHELLEY, ID 83274-5006
(208) 541-3140
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
59690
ID
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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