IDAHO NP CLINIC PLLC NPI 1790370765

NPI Information

IDAHO NP CLINIC PLLC is a primary care nurse practitioner in Boise, ID. IDAHO NP CLINIC PLLC NPI is 1790370765. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1883 WILDWOOD ST STE C
BOISE, ID
ZIP 83713-146
Phone: (662) 571-7651

The provider's authorized official is Jennifer Hofer .
The authorized official title is Owner and has the following contact phone number (208) 901-7006.

The CLIA number assigned to this NPI record is 13D2216619 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2021 and was last updated on 5/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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