Individual
MR. TIMOTHY FRANKLIN FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
500 W FORT ST, # 111, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W FORT ST, # 111, BOISE, ID 83702-4501
(208) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-1290A
ID
363LF0000X
Family Nurse Practitioner
200350127NP-FNP-PP
OR
Other
Enumeration date
07/26/2006
Last updated
07/19/2022
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