Individual
KASSANDRA LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
69658
ID
363LA2100X
Acute Care Nurse Practitioner
Primary
69658
ID
Other
Enumeration date
02/16/2023
Last updated
04/18/2023
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