Individual
TAYLOR FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
Mailing address
3881 S WOODCRAFT AVE, BOISE, ID 83716-7154
(208) 381-2711
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
6271474
ID
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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