Individual
JILL K DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3520 E LOUISE DR, MERIDIAN, ID 83642-6304
(208) 888-0909
(208) 888-5825
Mailing address
3520 E LOUISE DR, MERIDIAN, ID 83642-6304
(208) 888-0909
(208) 888-5825
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16506A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010164251
BLUE SHIELD OF IDAHO
—
05
—
807541000
—
ID
01
—
NPYY6
BLUE CROSS OF IDAHO
ID
Enumeration date
08/31/2006
Last updated
05/13/2021
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