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Individual

DR. KERRIANN BOANCA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 N ROBBINS RD STE 100, BOISE, ID 83702-4539
(208) 381-1615
(208) 381-5141
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
PG205706
OR
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
3271773
ID
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD210011692
DC

Other

Enumeration date
04/01/2020
Last updated
10/29/2025
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