Individual
NICOLE BOYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2705 E 17TH ST, AMMON, ID 83406-6601
(208) 757-3973
Mailing address
4587 1ST ST, IDAHO FALLS, ID 83401-3898
(208) 757-3973
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
73410
ID
Other
Enumeration date
07/08/2022
Last updated
07/08/2022
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