Individual
NICKI JO PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4378 S DA VINCI WAY, MERIDIAN, ID 83642
(208) 884-0110
(208) 884-4508
Mailing address
4378 S DA VINCI WAY, MERIDIAN, ID 83642
(208) 884-0110
(208) 884-4508
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-783A
ID
Other
Enumeration date
01/16/2007
Last updated
12/30/2019
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