Individual
NICHOLAS B HENRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3267
Mailing address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3267
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-16853
ID
Other
Enumeration date
05/24/2021
Last updated
09/10/2025
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