Individual
KATHERINE Q ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6165 W EMERALD ST, BOISE, ID 83704-8613
(208) 302-3500
(208) 302-3555
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 302-3500
(208) 302-3555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
59583
ID
Other
Enumeration date
11/21/2018
Last updated
01/18/2019
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