Individual
JUDY A KIENZLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.-C
Contact information
Practice address
1515 W STATE ST, BOISE, ID 83702-4039
(208) 345-6768
Mailing address
3340 E. GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A-094411
IA
363LF0000X
Family Nurse Practitioner
Primary
NP450A
ID
Other
Enumeration date
06/15/2006
Last updated
04/10/2009
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