Individual
TONI SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1111 S ORCHARD ST STE 155, BOISE, ID 83705-1963
(208) 333-0103
(208) 333-0105
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP458A
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP-458A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1342948
MEDICARE
ID
01
—
1356454839
NPI
ID
Enumeration date
08/17/2006
Last updated
02/22/2023
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