Individual
NATHAN WALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1052
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
(208) 422-1052
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
54442
ID
Other
Enumeration date
01/10/2025
Last updated
01/27/2025
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