Individual
KARA DEE BOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 CHANNING WAY STE 206, IDAHO FALLS, ID 83404-7546
(208) 529-2230
(208) 453-6142
Mailing address
PO BOX 277381, ATLANTA, GA 30384-7381
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
55419
ID
363LF0000X
Family Nurse Practitioner
GAA-NP000040
GA
Other
Enumeration date
03/17/2017
Last updated
06/04/2024
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