Individual
SAMANTHA KAITLIN LEGAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6933 W EMERALD ST, BOISE, ID 83704-8616
(208) 321-0634
Mailing address
7848 W MCMULLEN ST, BOISE, ID 83709-0839
(208) 353-2928
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8861276
ID
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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