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Individual

HUNTER NICOLE MARIE HARALSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
921 S 8TH AVE STOP 8253, POCATELLO, ID 83209-0002
(208) 282-4726
Mailing address
500 W FORT ST, BOISE, ID 83702-4501

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7971879
ID
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
07/27/2023
Last updated
01/13/2026
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