Individual
STACEY JEWELL FREITAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 882-4511
(208) 883-6571
Mailing address
PO BOX 9911, MOSCOW, ID 83843-0200
(208) 746-7555
(208) 746-7556
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7371198
ID
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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