KATRINA LARENE MACE

MERIDIAN, ID
NPI1477323947
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ID  78422)
Enumeration Date2024-01-05
Last Update Date2024-05-28
Business Address
KATRINA LARENE MACE
1047 S WELLS ST
MERIDIAN, ID 83642-7997
Phone number: 208-297-3428
Mailing Address
KATRINA LARENE MACE
1070 MAPLEWOOD ST
BURLEY, ID 83318-5511
Phone number: 208-431-4898
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