Provider Demographics
NPI:1083373427
Name:KALLIOKOSKI, MEGHANN ELAINE (DNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGHANN
Middle Name:ELAINE
Last Name:KALLIOKOSKI
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83653-0009
Mailing Address - Country:US
Mailing Address - Phone:208-461-7149
Mailing Address - Fax:208-467-3391
Practice Address - Street 1:201 S PARADISE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-5809
Practice Address - Country:US
Practice Address - Phone:208-585-0048
Practice Address - Fax:208-466-5359
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2024-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ID57422207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine