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1841728342
TRACY JUNGMAN
BOISE, ID
NPI
1841728342
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Former Name
TRACY WALLACE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID 56035)
Enumeration Date
2017-05-26
Last Update Date
2022-07-21
Business Address
TRACY JUNGMAN NP
417 S 6TH ST
BOISE, ID 83702-7632
Phone number: 208-577-4460
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Mailing Address
TRACY JUNGMAN NP
3561 N LA FONTANA WAY
BOISE, ID 83702-1526
Phone number: 208-409-3972
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