Individual
VICKI FUNAIOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1126 W RIVER ST, BOISE, ID 83702-7047
(208) 331-1155
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
N8640
ID
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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