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1487078911
JAMIE BROOKE PETERSON
BOISE, ID
NPI
1487078911
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1236)
Enumeration Date
2014-02-04
Last Update Date
2024-10-22
Business Address
JAMIE BROOKE PETERSON PA-C
10394 W HENRYS LAKE DR
BOISE, ID 83709-6283
Phone number: 208-440-0255
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Mailing Address
JAMIE BROOKE PETERSON PA-C
1325 NE 7TH ST
GRANTS PASS, OR 97526-1358
Phone number: 541-460-5331
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