Individual
JERILYN R BODEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501
(512) 730-3056
(888) 730-1925
Mailing address
7500 RIALTO BLVD STE 1-140, AUSTIN, TX 78735-8534
(512) 730-3056
(888) 730-1925
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
60187
ID
Other
Enumeration date
12/17/2018
Last updated
02/19/2024
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