Individual
JAMIE GUDMUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 W MAIN ST, SAINT ANTHONY, ID 83445-2113
(208) 624-2969
Mailing address
30 W MAIN ST, SAINT ANTHONY, ID 83445-2113
(208) 624-2969
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1574A
ID
Other
Enumeration date
06/15/2015
Last updated
01/02/2023
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