Individual
JAMIE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 S IVY ST, APT D, NAMPA, ID 83686-6029
(208) 989-8518
Mailing address
1312 S IVY ST, D, NAMPA, ID 83686-6029
(208) 989-8518
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
00000000000
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000000000
HEALTH INSURANCE EXCHANGE ENROLLMENT
ID
Enumeration date
04/02/2014
Last updated
04/02/2014
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