Individual
TRACY JUNGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
417 S 6TH ST, BOISE, ID 83702-7632
(208) 577-4460
(208) 577-4469
Mailing address
3561 N LA FONTANA WAY, BOISE, ID 83702-1526
(208) 409-3972
(208) 381-6870
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
56035
ID
Other
Enumeration date
05/26/2017
Last updated
07/21/2022
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