Organization
DNA WITH TINA LLC
Active
Organization
DNA WITH TINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE FUHRMAN MLADENKA WHNP-BC, DNP (OWNER)
(208) 240-4785
Entity
Organization
Contact information
Practice address
1951 BENCH RD, POCATELLO, ID 83201-2073
(208) 240-4785
Mailing address
1951 BENCH RD, POCATELLO, ID 83201-2073
(208) 240-4785
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/09/2012
Last updated
09/25/2012
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