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Organization

BORRON FAMILY MEDICINE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BROOKNEY RAEANNE BORRON MSN, FNP-C (OWNER)
(208) 866-1428
Entity
Organization

Contact information

Practice address
790 W USTICK RD, STE 110, MERIDIAN, ID 83646-5558
(208) 639-3990
(208) 639-3992
Mailing address
790 W USTICK RD, SUITE 110, MERIDIAN, ID 83646-5558
(208) 639-3990
(208) 639-3992

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
363LF0000X
Family Nurse Practitioner
Primary
NP-923A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033424429
ID
Enumeration date
08/10/2010
Last updated
02/28/2013
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