Individual
KELLI SWANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5010 ROCK CREEK DR, IDAHO FALLS, ID 83401-6531
(208) 284-9153
Mailing address
5010 ROCK CREEK DR, IDAHO FALLS, ID 83401-6531
(208) 284-9153
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
56474
ID
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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