Individual
MIRIAH JEAN GRAYBILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 POLE LINE RD W STE 2A, TWIN FALLS, ID 83301-4270
(208) 814-8600
(208) 814-8942
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
77319
ID
Other
Enumeration date
08/21/2023
Last updated
10/26/2023
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