Individual
MRS. BECKY M. ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1072 N LIBERTY ST STE 100, BOISE, ID 83704-8708
(208) 302-1200
(208) 302-1255
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP459A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805737400
—
ID
01
—
NPGZ4
BLUE CROSS OF ID
ID
Enumeration date
11/08/2005
Last updated
09/15/2022
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