Individual
KATHERINE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N LIBERTY ST STE 204, BOISE, ID 83704-8707
(208) 367-4063
Mailing address
900 N LIBERTY ST STE 204, BOISE, ID 83704-8707
(208) 367-4063
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
N-38328
ID
Other
Enumeration date
07/16/2026
Last updated
07/16/2026
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