NPI 1194229310

Jeffery Thomas Ly, RN

Practitioner Registered Nurse Caldwell, ID

Practice location

Address: 11961 Pheasant Run St, Caldwell, ID 83605-5082
Phone: (208) 590-8166

Registered specialties

Registered Nurse Primary

Nursing Service Providers Taxonomy 163W00000X Licence 46147 (ID)

Other Registered Nurse providers in Idaho →

Registry record

NPI: 1194229310
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Mar 2018
Record last updated: 21 Mar 2018

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.