Individual
KENNETH JAMES GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1950 SAINT CLAIR RD, IDAHO FALLS, ID 83404-6306
(208) 569-8249
Mailing address
1950 SAINT CLAIR RD, IDAHO FALLS, ID 83404-6306
(208) 569-8249
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F12230320
ID
Other
Enumeration date
12/14/2023
Last updated
02/21/2024
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