Individual
MRS. LYNDA J MARICLE-KUWAHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
3852 HIGHWAY 21, IDAHO CITY, ID 83631-4176
(208) 392-4544
(208) 392-4128
Mailing address
3852 HIGHWAY 21, P.O. BOX 554, IDAHO CITY, ID 83631-4176
(208) 392-4544
(208) 392-4128
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP289
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP497
BLUE CROSS
ID
Enumeration date
01/10/2006
Last updated
12/18/2007
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