Individual
KARISSA I NIECE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3515 W GREENBRIER DR, BOISE, ID 83705-4514
(208) 241-4226
Mailing address
3515 W GREENBRIER DR, BOISE, ID 83705-4514
(208) 241-4226
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
ID
Other
Enumeration date
11/14/2019
Last updated
12/26/2019
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