Individual
MARILEE KURACINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
895 N 6TH E, ST LUKE'S ELMORE, MOUNTAIN HOME, ID 83647-2207
(208) 580-2683
Mailing address
PO BOX 1004, NAMPA, ID 83653-1004
(208) 546-2491
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M5035
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804267000
—
ID
Enumeration date
06/21/2006
Last updated
11/10/2014
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