| Organization Name: | BORRON FAMILY MEDICINE PLLC |
| NPI Number: | 1033424429 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BROOKNEY RAEANNE BORRON (OWNER) |
| Mailing Address: | 790 W Ustick Rd Ste 110 Meridian |
| State: | ID US |
| Postal Code: | 836465558 |
| Phone Number: | 2086393990 |
| Fax Number: | 2086393992 |
| NPI Enumeration Date: | 08/10/2010 |
| NPI Last Update Date: | 02/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |