Individual
SHARON L KRASOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., RN, FNP-BC
Contact information
Practice address
3101 E STATE ST STE 2120, EAGLE, ID 83616-6232
(208) 473-3275
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0121363
CO
363L00000X
Nurse Practitioner
N-50902-NP-1629A
ID
363L00000X
Nurse Practitioner
Primary
NP-1629A
ID
Other
Enumeration date
06/17/2013
Last updated
03/31/2022
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