Individual
KRISTINA M KNIFFEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PN-14938
Contact information
Practice address
717 MISSION RD, FORT HALL, ID 83203-0306
(208) 238-2400
(208) 238-5462
Mailing address
717 MISSION RD, PO BOX 306, FORT HALL, ID 83203-0306
(208) 238-2400
(208) 238-5462
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-14938
ID
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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