Individual
DR. COURTNEY HOBZA BANNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
444 W FORT ST., CRH 2ND FLOOR, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
444 W FORT ST., CRH 2ND FLOOR, BOISE, ID 83702-4535
(208) 422-1018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-44308
KS
207Q00000X
Family Medicine Physician
R6654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
399302401
—
TX
Enumeration date
06/08/2016
Last updated
10/26/2023
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