Individual
ANNA PRUDNIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1109 W LOON ST, MERIDIAN, ID 83642-2895
(208) 440-0044
Mailing address
1109 W LOON ST, MERIDIAN, ID 83642-2895
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
64467
ID
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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