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Individual

KAYLA WHITNEY GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
(208) 381-4025
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
10015249
OR
363LF0000X
Family Nurse Practitioner
Primary
77655
ID

Other

Enumeration date
09/25/2023
Last updated
01/09/2024
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