Individual
STEPHANIE MARRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 345-0715
(208) 345-1142
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60583927
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
70203
ID
Other
Enumeration date
08/21/2017
Last updated
07/08/2024
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