Individual
MISS MARY CHRISTINE LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
1786 N PRESTWICK WAY, EAGLE, ID 83616-6688
(208) 709-4992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1436A
ID
363LF0000X
Family Nurse Practitioner
Primary
N-31924
ID
363LF0000X
Family Nurse Practitioner
NP-1436A
ID
Other
Enumeration date
05/28/2014
Last updated
05/14/2024
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