# TONI SPARKS, PA

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

## Provider details

- **NPI number:** 1427508514
- **Authorized official:** TONI SPARKS NP (NP/OWNER)
- **Authorized official phone:** (208) 333-0103

## Contact information

- **Practice address:** 1111 S ORCHARD ST, STE 155, BOISE, ID 83705-1966
- **Practice address phone:** (208) 333-0103
- **Practice address fax:** (208) 333-0105
- **Mailing address:** 1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
- **Mailing address phone:** (208) 287-9420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | NP-458A | ID | Yes |

## Other

- **Enumeration date:** 10/12/2016
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | NP-458A | LICENSE | ID |