Larisa Kogan NP

NPI 1740680149 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1740680149
Gender Female
Enumeration Date 09/04/2014
Last Updated 09/04/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
308 E HAWAII AVE
NAMPA ID, 83686-6013, US
Phone (208) 467-6700
Fax
Business Location
190 E BANNOCK ST
BOISE ID, 83712-6241, US
Phone (208) 381-2222
Fax
Toxanomy
Taxonomy Code 363L00000X
License State Idaho
License Number NP0000
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According to our database, Larisa Kogan NP NPI is 1740680149, taxonomy code is 363L00000X and license number is NP0000, license state is located at Idaho. Larisa Kogan NP physically located at 308 E Hawaii Ave, Nampa ID, 83686-6013. NPI Number Larisa Kogan NP has the Individual type.

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1740680149 NPI number is provided on an as is basis without warranty of any kind. 1740680149 is maintained by the National Plan & Provider Enumeration System. The contents of Larisa Kogan NP are for informational purposes only.