Individual
KIRSTEN M DEUTSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3301 N SAWGRASS WAY, BOISE, ID 83704-4493
(208) 375-0862
(208) 375-2658
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2000172092
MO
207Q00000X
Family Medicine Physician
50492
MN
207Q00000X
Family Medicine Physician
Primary
M11773
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205171101
—
MO
01
—
80164827
RR MEDICARE
MO
Enumeration date
05/20/2006
Last updated
12/29/2012
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