Individual
SUMMER LYNN COCKAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4599
(208) 422-1000
Mailing address
6340 S IRONWOOD AVE, BOISE, ID 83709-1243
(208) 284-0439
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
58511
ID
Other
Enumeration date
06/12/2018
Last updated
06/12/2018
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