Individual
MR. JEREMY GARY RIVETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1092
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1092
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
Primary
8171888
ID
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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