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1740680149
LARISA KOGAN
NAMPA, ID
NPI
1740680149
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Former Name
LARISA KRAMER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID NP0000)
Enumeration Date
2014-09-04
Last Update Date
2014-09-04
Business Address
LARISA KOGAN NP
308 E HAWAII AVE
NAMPA, ID 83686-6013
Phone number: 208-467-6700
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Mailing Address
LARISA KOGAN NP
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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