Individual
MR. MAX BOYD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NNP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2074
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
739902
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
61248
ID
Other
Enumeration date
10/15/2018
Last updated
03/19/2024
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