CODY JOHANNA BONINE FNP
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1528730165- Provider Type
- Individual Provider (NPI-1)
- Credentials
- FNP
- Status
- Active
Contact & Location
- Address
- 21 N FISHER PARK WAY, EAGLE, ID, 836164796
- Phone
- (208) 996-8181
- Fax
- (208) 549-7880
Specialties & Taxonomies
Nurse Practitioner, Family
Primary License: ID #69928