Individual
TAYLOR KAYLYN FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 204-1289
Mailing address
10722 W JEWELL LN UNIT 101, BOISE, ID 83713-8079
(409) 893-1182
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3171368
ID
Other
Enumeration date
07/15/2025
Last updated
07/28/2025
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