Individual
NATE BOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, MSN, FNP-BC
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 227-2001
Mailing address
1710 MARSALA CT, IDAHO FALLS, ID 83401-6283
(208) 552-0478
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N-37724
ID
363LF0000X
Family Nurse Practitioner
Primary
NP-1159A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP-1159A
STATE LICENSE
ID
Enumeration date
05/04/2012
Last updated
06/21/2013
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