Individual
KILEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2912 S COLORADO AVE, BOISE, ID 83706-4732
(208) 949-4374
Mailing address
PO BOX 6130, BOISE, ID 83707-6130
(208) 949-4374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-36036
ID
Other
Enumeration date
08/15/2021
Last updated
08/15/2021
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