Individual
KRISTEN FIORENTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
520 S EAGLE RD STE 2104, MERIDIAN, ID 83642-6363
(208) 706-0201
(208) 706-0202
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
(888) 972-4280
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8929
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806862700
—
ID
Enumeration date
05/16/2006
Last updated
06/11/2024
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