Individual
KIMERENG KIPCHUMBA KIPSUGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1883 WILDWOOD ST STE C, BOISE, ID 83713-5146
(208) 901-7006
Mailing address
1883 WILDWOOD ST STE C, BOISE, ID 83713-5146
(208) 901-7006
(949) 561-4801
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
62135
ID
Other
Enumeration date
07/22/2019
Last updated
06/30/2021
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