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General NPI Number Information
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NPI Number | 1538505276
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Entity Type | Individual
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Provider Name | ABBY M. LUENSMANN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 11197 W FAIRVIEW AVE
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City | BOISE
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State | ID
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Zip | 83713-7935
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Country | US
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Telephone | 208-378-8011
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Fax | 208-322-8095
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Provider Business Mailing Address
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Address Line | PO BOX 191050
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City | BOISE
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State | ID
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Zip | 83719-1050
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Country | US
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Telephone | 208-985-6500
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Fax | 208-955-6501
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A125780
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M-12654
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License Number State | ID
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