Individual
KATHLEEN TIERNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
701 E PARKCENTER BLVD, BOISE, ID 83706-6528
(208) 381-6500
Mailing address
1109 W HOLLAND AVE, NAMPA, ID 83651-1867
(208) 965-7795
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8961768
ID
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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