Individual
NICOLE MARIE JUSTESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 N CRESTMONT DR STE A, MERIDIAN, ID 83642-2177
(208) 288-4200
Mailing address
2454 N MEADOWGLEN PL, MERIDIAN, ID 83646-5792
(208) 861-7756
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3961262
ID
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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