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1457879975
MARK AARON PHELAN
BOISE, ID
NPI
1457879975
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: ID N-29179)
Enumeration Date
2017-09-05
Last Update Date
2022-07-21
Business Address
MARK AARON PHELAN RN
779 S. TENNYSON WAY
BOISE, ID 83709
Phone number: 208-724-1829
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Mailing Address
MARK AARON PHELAN RN
779 S TENNYSON WAY
BOISE, ID 83709-7738
Phone number: 208-724-1829
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