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Individual

DR. LISA M NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-7350
(208) 367-3951
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301085654
MI
208M00000X
Hospitalist Physician
Primary
M-10662
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
808446500
ID
Enumeration date
03/20/2007
Last updated
10/31/2011
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