TAMARA FREDRICKSON

BOISE, ID
NPI1336471911
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: ID  NP-319A)
Enumeration Date2010-02-05
Last Update Date2010-02-05
Business Address
-- TAMARA FREDRICKSON
8169 W VICTORY RD
BOISE, ID 83709-4164
Phone number: 208-854-4173
Mailing Address
-- TAMARA FREDRICKSON
8169 W VICTORY RD
BOISE, ID 83709-4164
Phone number: 208-854-4173