# HALCYON INFUSIONS & THERAPEUTICS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154188050
- **Authorized official:** MATTHEW FOWLER NP (NURSE PRACTITIONER/OWNER)
- **Authorized official phone:** (208) 546-3650

## Contact information

- **Practice address:** 1611 12TH AVE RD STE A, NAMPA, ID 83686-6182
- **Practice address phone:** (208) 546-3650
- **Mailing address:** 1123 12TH AVE RD \# 325, NAMPA, ID 83686-5738
- **Mailing address phone:** (208) 546-3650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/06/2024
- **Last updated:** 05/28/2025