Individual
JAIME IVAN DELGADO CALDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-4100
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8866
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
75819
ID
363LF0000X
Family Nurse Practitioner
75819
ID
Other
Enumeration date
03/23/2023
Last updated
04/18/2023
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