Individual
KYLEE MUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2347 E GALA ST, MERIDIAN, ID 83642-4881
(208) 323-3767
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F05210607
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F05210607
AANP
ID
Enumeration date
05/24/2021
Last updated
07/22/2022
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