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Individual

KATHRYN SISTERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2121
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 367-4096

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
161452
AZ
163W00000X
Registered Nurse
4704244332
MI
163W00000X
Registered Nurse
643423
CA
363LA2100X
Acute Care Nurse Practitioner
7710
AZ
363LF0000X
Family Nurse Practitioner
17433
CA
363LF0000X
Family Nurse Practitioner
3577
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
59073
ID

Other

Enumeration date
01/09/2008
Last updated
08/23/2018
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