Individual
RACHAEL L PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 E WARM SPRINGS AVE STE B, BOISE, ID 83712-6243
(208) 381-6930
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-6930
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1257A
ID
Other
Enumeration date
03/18/2013
Last updated
04/24/2013
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