Organization
ILLUMINATION WOMEN'S HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KANDISS INMAN WHNP-BC, MSN, NCMP (NURSE PRACTITIONER/OWNER)
(208) 780-9295
Entity
Organization
Contact information
Practice address
4477 W EMERALD ST STE C200, BOISE, ID 83706-2074
(208) 780-9295
(855) 490-9559
Mailing address
4477 W EMERALD ST STE C200, BOISE, ID 83706-2074
(208) 780-9295
(855) 490-9559
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/13/2023
Last updated
01/02/2025
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