Healthcare Provider Details

I. General information

NPI: 1003569120
Provider Name (Legal Business Name): KARI CHRISTINA STORJHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARI CHRISTINA STORJOHANN

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 W ST LUKES DR STE 270
NAMPA ID
83687-7912
US

IV. Provider business mailing address

190 E BANNOCK ST
BOISE ID
83712-6241
US

V. Phone/Fax

Practice location:
  • Phone: 208-205-7820
  • Fax: 208-205-7822
Mailing address:
  • Phone: 208-381-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6471581
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: