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1013594092
EVITA KVISTA
EAGLE, ID
NPI
1013594092
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: ID 65119)
Enumeration Date
2021-03-25
Last Update Date
2021-03-25
Business Address
EVITA KVISTA
225 S LINDER RD APT B301
EAGLE, ID 83616-4426
Phone number: 208-412-9622
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Mailing Address
EVITA KVISTA
225 S LINDER RD APT B301
EAGLE, ID 83616-4426
Phone number: 208-412-9622
Copy
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