Individual
JORDYN ASHLIE OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2609 S 10TH AVE, CALDWELL, ID 83605-6816
(208) 454-2766
Mailing address
2609 S 10TH AVE, CALDWELL, ID 83605-6816
(208) 454-2766
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57711
ID
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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