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1275175291
HAILEY M GORDON
MERIDIAN, ID
NPI
1275175291
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID 53504)
Enumeration Date
2019-10-10
Last Update Date
2021-07-14
Business Address
HAILEY M GORDON PA-C
260 S TEN MILE RD
MERIDIAN, ID 83642-6100
Phone number: 208-809-2872
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Mailing Address
HAILEY M GORDON PA-C
PO BOX 191050
BOISE, ID 83719-1050
Phone number: 208-955-6500
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