KRISTI LYNN MALICOAT

GRAND VIEW, ID
NPI1013232834
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: ID  PN-12009)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: OR  200930022LPN)
164W00000X Licensed Practical Nurse
(Licence: IN  27036628A)
164W00000X Licensed Practical Nurse
(Licence: NV  LPN11423)
164X00000X Licensed Vocational Nurse
(Licence: CA  VN249377)
Enumeration Date2010-04-05
Last Update Date2011-05-09
Business Address
-- KRISTI LYNN MALICOAT LPN
23220 RIVER RD
GRAND VIEW, ID 83624-5009
Phone number: 208-834-2860
Mailing Address
-- KRISTI LYNN MALICOAT LPN
PO BOX 632
GRAND VIEW, ID 83624-0632
Phone number: 208-834-2860