Individual
MCKINZEY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
(208) 302-5155
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95281611
CA
363L00000X
Nurse Practitioner
Primary
8871250
ID
363L00000X
Nurse Practitioner
95032408
CA
Other
Enumeration date
08/29/2024
Last updated
06/12/2025
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