Individual
VANESSA R HOLSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3525 E LOUISE DR STE 500, MERIDIAN, ID 83642-6305
(208) 706-7050
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP493A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805914000
—
ID
Enumeration date
02/26/2007
Last updated
09/28/2022
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