Individual
JACQUELINE BAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-7340
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
53154
CA
363A00000X
Physician Assistant
Primary
PA-1704
ID
Other
Enumeration date
01/22/2016
Last updated
01/29/2026
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