Individual
MRS. LEEANN BOLGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
502 TYHEE AVE, AMERICAN FALLS, ID 83211-1224
(208) 221-7777
Mailing address
510 ROOSEVELT ST, AMERICAN FALLS, ID 83211-1362
(208) 221-7777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
69594
ID
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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