MR. Jeffery Thomas Ly, RN

NPI #1194229310 in Caldwell, Idaho

Provider Information

NPI Number
1194229310
Entity Type
Individual
Name
MR. Jeffery Thomas Ly, RN
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Registered Nurse
Credential
RN
Enumeration Date
Mar 21, 2018
Last Updated
Mar 21, 2018

Practice Location

Address
11961 PHEASANT RUN ST
State
Idaho
ZIP Code
83605-5082
Phone
(208) 590-8166

Specialties & Taxonomy Codes

Specialty
Registered Nurse

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