Individual
COLTER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
Mailing address
780 S TENNYSON WAY, BOISE, ID 83709-7738
(208) 251-9519
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
60327
ID
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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