Individual
KENNETH JENSON BRAMWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M8736
ID
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
M8736
ID
Other
Enumeration date
05/31/2006
Last updated
09/22/2020
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