Individual
NICOLE MELISSA GARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25095 HOMEDALE RD, WILDER, ID 83676-5811
(208) 695-8490
Mailing address
25095 HOMEDALE RD, WILDER, ID 83676-5811
(208) 695-8490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
99-4989751
ID
Other
Enumeration date
12/17/2025
Last updated
01/15/2026
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