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Individual

DONNA MARIE PUNINANI MONIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
14890
HI
164W00000X
Licensed Practical Nurse
202206783LPN
OR
164W00000X
Licensed Practical Nurse
Primary
55197
ID

Other

Enumeration date
07/27/2022
Last updated
07/27/2022
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