Individual
ALAN KELLY WINWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 850-2110
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 850-2110
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
18335
ID
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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