Organization
HALCYON INFUSIONS & THERAPEUTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FOWLER NP (NURSE PRACTITIONER/OWNER)
(208) 546-3650
Entity
Organization
Contact information
Practice address
1611 12TH AVE RD STE A, NAMPA, ID 83686-6182
(208) 546-3650
Mailing address
1123 12TH AVE RD # 325, NAMPA, ID 83686-5738
(208) 546-3650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
05/28/2025
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