Individual
KEVIN SKAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE RN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1012
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-44239
ID
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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