Individual
MR. BREKK C MACPHERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-3971
(208) 381-2566
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024175251
VA
363LA2100X
Acute Care Nurse Practitioner
NP-963A
ID
Other
Enumeration date
04/08/2010
Last updated
04/22/2024
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