Individual
NICOLE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4696 W OVERLAND RD STE 182, BOISE, ID 83705-2878
(208) 421-6612
Mailing address
4696 W OVERLAND RD STE 182, BOISE, ID 83705-2878
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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