Individual
NICHOLAS WREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E PARK BLVD STE 120, BOISE, ID 83712-7793
(208) 381-4100
(208) 381-4101
Mailing address
500 W FORT ST # 111R, BOISE, ID 83702-4599
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MRM-2238
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2023
Last updated
08/15/2023
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