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Individual

JESSICA KARINA CUEVAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13284 WILLIS RD, CALDWELL, ID 83607-7790
(801) 879-2086
Mailing address
13284 WILLIS RD, CALDWELL, ID 83607-7790
(801) 879-2086

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
190344465
UT

Other

Enumeration date
02/20/2017
Last updated
02/20/2017
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Product
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  • Eligibility checks
  • EDI platform