| Organization Name: | KUNA FAMILY MEDICAL CLINIC, P. A. |
| NPI Number: | 1740326990 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MYRNA C. FISHER (OWNER) |
| Mailing Address: | 708 E Wythe Creek Ct Ste 103 Kuna |
| State: | ID US |
| Postal Code: | 836345005 |
| Phone Number: | 2089225130 |
| Fax Number: | 2089225132 |
| NPI Enumeration Date: | 01/29/2007 |
| NPI Last Update Date: | 12/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP193A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |