Individual
KAREN BERMENSOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
5823 E PLAYWRIGHT ST, BOISE, ID 83716-5500
(208) 590-9981
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-47936
ID
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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