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General NPI Number Information
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NPI Number | 1518771435
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Entity Type | Individual
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Provider Name | KALLI ANN GILLIHAN FNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 6235 N LINDER RD SUITE 20
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City | MERIDIAN
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State | ID
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Zip | 83646
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Country | US
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Telephone | 208-600-1080
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 N CALCUTTA AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-7824
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Country | US
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Telephone | 208-559-3445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2571946
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License Number State | ID
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