Individual
DR. LEONA JO'ANNE' CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1655 W FAIRVIEW AVE STE 206, BOISE, ID 83702-5190
(208) 395-0000
(208) 395-0009
Mailing address
1655 W FAIRVIEW AVE STE 206, BOISE, ID 83702-5190
(208) 395-0000
(208) 395-0009
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NP-157A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805703400
—
ID
Enumeration date
12/13/2006
Last updated
04/23/2009
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