Individual ProviderCeleste JolyPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address305 E Jefferson St, Boise, ID 83712-6231(208) 381-7370(208) 706-5437PECOS EnrollmentBased on the most recent information from CMS, provider Celeste Joly does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1184494460Provider TypeIndividualFull NameJoly, CelesteGenderFemaleSole ProprietorNoEnumeration Date1/8/2024Last Updated10/18/2024Contact InformationPractice LocationPractice Address305 E Jefferson St, Boise, ID 83712-6231Phone(208) 381-7370Fax(208) 381-7377Mailing LocationMailing Address190 E Bannock St, Boise, ID 83712-6241Phone(208) 706-5437FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense2461474Idaho