Individual
KELLIE FRANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2107 BLAINE ST, CALDWELL, ID 83605-4427
(208) 455-1094
Mailing address
30 HUNTER LN, CAMP HILL, PA 17011-2400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
56554
ID
163W00000X
Registered Nurse
95123989
CA
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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