Most Relevant Information
Provider Data
| NPI Number: | 1003639873 |
| Provider Name: | JACQUELINE STEAN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | RN9592562 |
Most Important Dates
| Enumeration Date: | 11/01/2024 |
| Last Updated: | 11/01/2024 |
Provider Practice Location
PO BOX 1155
DRIGGS
ID
834221155
Practice Location Phone/Fax
| Phone: | 9084892861 |
| Fax: |
Provider Mailing Location
PO BOX 1155
DRIGGS
ID
834221155
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |