Individual
KAITLIN ANN ROURK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2490
Mailing address
2841 S TAGGART LN, BOISE, ID 83705-4146
(208) 982-0169
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9530
ID
Other
Enumeration date
08/11/2021
Last updated
03/05/2026
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