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Organization
TONI SPARKS, PA
Active
Organization
TONI SPARKS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI SPARKS NP (NP/OWNER)
(208) 333-0103
Entity
Organization
Contact information
Practice address
1111 S ORCHARD ST, STE 155, BOISE, ID 83705-1966
(208) 333-0103
(208) 333-0105
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-458A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP-458A
LICENSE
ID
Enumeration date
10/12/2016
Last updated
03/07/2023
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