Individual
K DENISE RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
800 FALLS AVE, SUITE 2, TWIN FALLS, ID 83301-3366
(208) 734-6091
Mailing address
800 FALLS AVE, SUITE 2, TWIN FALLS, ID 83301-3366
(208) 734-6091
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17497A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17497A
TEMPORARY NURSE PRAC LIC.
ID
Enumeration date
06/21/2007
Last updated
07/08/2007
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