Individual
DR. NINA KELLIE LATEEFEE ABUL-HUSN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MSPH
Contact information
Practice address
2785 BANNOCK HWY, POCATELLO, ID 83204-3607
(208) 904-2654
Mailing address
1603 12TH AVE RD STE B, NAMPA, ID 83686-6100
(120) 844-2009
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
M-13784
ID
207QA0401X
Addiction Medicine (Family Medicine) Physician
MED-PHYS-COM-LIC-147
MT
208D00000X
General Practice Physician
M-13784
ID
208D00000X
General Practice Physician
MED-PHYS-COM-LIC-147
MT
Other
Enumeration date
06/11/2012
Last updated
12/23/2025
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