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Individual

MR. BLAKE TAYLOR THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN, APRN, FNP-C

Contact information

Practice address
800 E PARK BLVD, BOISE, ID 83712-7763
(208) 381-4210
(208) 381-2045
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
50167
ID
363LF0000X
Family Nurse Practitioner
Primary
69119
ID

Other

Enumeration date
03/12/2019
Last updated
02/02/2026
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