Individual
MICHELLE KRUSE IMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
980 BURLEY AVE, BUHL, ID 83316-1849
(208) 814-9150
(208) 814-9151
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6261075
ID
Other
Enumeration date
06/25/2024
Last updated
01/28/2026
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