Individual
KELLY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3520 E LOUISE DR, MERIDIAN, ID 83642-6304
(208) 888-0909
(208) 888-5825
Mailing address
3520 E LOUISE DR, MERIDIAN, ID 83642-6304
(208) 888-0909
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1461A
ID
Other
Enumeration date
07/28/2014
Last updated
05/13/2021
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