Individual
DR. KAITLIN C NEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8950 W EMERALD ST STE 168, BOISE, ID 83704-8296
(208) 321-1209
(208) 321-1211
Mailing address
8950 W EMERALD ST STE 168, BOISE, ID 83704-8296
(208) 321-1209
(208) 321-1211
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
16821
NV
207X00000X
Orthopaedic Surgery Physician
6556
NE
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
16821
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053609073
—
NV
01
—
13885664
CAQH
—
Enumeration date
07/11/2011
Last updated
04/22/2024
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