Individual
KENDRA COONSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6140 W CURTISIAN AVE STE 200, BOISE, ID 83704-0107
(208) 302-0000
(208) 302-0055
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-0000
(208) 302-0055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
59356
MN
207RI0011X
Interventional Cardiology Physician
Primary
M-15838
ID
207RI0011X
Interventional Cardiology Physician
MD182707
OR
Other
Enumeration date
07/02/2014
Last updated
10/17/2024
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