Individual
KELSEY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
3280 E LANARK DR, MERIDIAN, ID 83642-5982
(208) 377-4400
(208) 377-4416
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61011
ID
Other
Enumeration date
04/03/2019
Last updated
08/08/2019
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