East Boise County Medical Clinic

NPI #1255608238 in Boise, Idaho

Provider Information

NPI Number
1255608238
Entity Type
Organization
Organization Name
East Boise County Medical Clinic
Primary Specialty
Nurse Practitioner - Family
Enumeration Date
Nov 19, 2011
Last Updated
Nov 19, 2011

Practice Location

Address
3852 HIGHWAY 21
City
Boise
State
Idaho
ZIP Code
83716
Phone
(208) 392-4544

Authorized Official

Name
LYNDA JOANNE MARICLE-KUWAHARA, APRN-C
Title
EXECUTIVE DIRECTOR
Phone
(208) 392-4544

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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