Individual
GINA MARIE KOVAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1092
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1092
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
49304
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49304
NURSING LISCENSE
ID
Enumeration date
09/30/2022
Last updated
10/04/2022
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