Organization
REVOLUTIONARY MEDICINE OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY D ROBBINS NP (OWNER)
(208) 871-0297
Entity
Organization
Contact information
Practice address
4776 N FIVE MILE RD STE 101, BOISE, ID 83713-2715
(986) 777-0278
(208) 658-9501
Mailing address
2536 CANYON RD S, MELBA, ID 83641-5258
(208) 871-0297
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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