Individual
MARIA CHANEL GRUVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083
Mailing address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
55485
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55485
RN NUMBER
ID
Enumeration date
04/26/2021
Last updated
04/26/2021
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