Individual
ANDREW THOMAS NILSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 N SISTER CATHERINE WAY, NAMPA, ID 83687-3133
(208) 302-7000
(208) 302-7055
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-17732
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/30/2021
Last updated
05/30/2024
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