Individual
KABRINA KAY LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1028 N SHILLING AVE, BLACKFOOT, ID 83221-1845
(208) 604-0208
Mailing address
1028 N SHILLING AVE, BLACKFOOT, ID 83221-1845
(208) 604-0208
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
68989
ID
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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