Organization
KUNA FAMILY MEDICAL CLINIC, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MYRNA C. FISHER ARNP (OWNER)
(208) 922-5130
Entity
Organization
Contact information
Practice address
708 E WYTHE CREEK CT STE 103, KUNA, ID 83634-5005
(208) 922-5130
(208) 922-5132
Mailing address
PO BOX 68, KUNA, ID 83634-0068
(208) 922-5130
(208) 922-5132
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP193A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804073900
—
ID
Enumeration date
01/29/2007
Last updated
12/02/2010
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