Individual
DEBRA S DEMINT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, VRC
Contact information
Practice address
3243 S TERRA DR, BOISE, ID 83709-3833
(208) 340-3411
Mailing address
3243 S TERRA DR, BOISE, ID 83709-3833
(208) 340-3411
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
23402
ID
163WC0400X
Case Management Registered Nurse
Primary
23402
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23402
IDAHO STATE BOARD OF NURSING
ID
Enumeration date
06/24/2022
Last updated
06/24/2022
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