Individual
NURUDEEN IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
999 N CURTIS RD STE 415, BOISE, ID 83706-1334
(208) 302-2600
(208) 302-2625
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
75389
ID
363LG0600X
Gerontology Nurse Practitioner
Primary
75389
ID
Other
Enumeration date
02/16/2023
Last updated
06/02/2023
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