NPI 1043694425

Jessica Vickers

Practitioner Pharmacist Twin Falls, ID

Practice location

Address: 1611 Blue Lakes Blvd N, Twin Falls, ID 83301-3374
Phone: (208) 736-3321

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence P7210 (ID)

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Registry record

NPI: 1043694425
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Jul 2015
Record last updated: 15 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.