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1265205850
NICOLE LYNNE PETERSEN
BOISE, ID
NPI
1265205850
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: ID 58927)
Enumeration Date
2023-11-06
Last Update Date
2023-11-06
Business Address
NICOLE LYNNE PETERSEN
417 S 6TH ST
BOISE, ID 83702-7632
Phone number: 208-577-4400
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Mailing Address
NICOLE LYNNE PETERSEN
3002 BRISTOL AVE
CALDWELL, ID 83605-1644
Phone number: 208-803-4748
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