JACQUELINE BAGGS
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1932566874- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 305 E JEFFERSON ST, BOISE, ID, 837126231
- Phone
- (208) 381-7340
Specialties & Taxonomies
Physician Assistant
Primary License: ID #PA-1704
Physician Assistant
License: CA #53154
All Addresses
MAILING
190 E BANNOCK ST
BOISE, ID, 837126241