Individual
ASHLEY DAWN MCCUISTION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
280 E CORPORATE DR STE 200, MERIDIAN, ID 83642-2953
(208) 283-7314
Mailing address
13075 W PEACHLEAF CT, BOISE, ID 83713-1959
(208) 794-1207
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2561174
ID
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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