Individual
KRISTIE GLEN KARROUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3320 S 25TH E, IDAHO FALLS, ID 83404-4606
(208) 569-9031
Mailing address
5480 GLENEAGLES DR, IDAHO FALLS, ID 83401-6315
(208) 569-9031
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
57631
ID
363LP0200X
Pediatric Nurse Practitioner
Primary
PENDING
ID
Other
Enumeration date
12/13/2017
Last updated
03/17/2018
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