Individual
KIMBERLEE BRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN LMT
Contact information
Practice address
5460 W FRANKLIN RD STE H, BOISE, ID 83705-1080
(208) 890-1109
Mailing address
5538 S ADONIS PL, BOISE, ID 83716-6950
(208) 890-1109
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MASG-287
ID
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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