Individual
STEPHANIE LARIE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702
(208) 422-1000
(208) 302-5455
Mailing address
500 W FORT ST, BOISE, ID 83702
(208) 422-1000
(208) 302-5455
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
55369
ID
Other
Enumeration date
06/07/2017
Last updated
03/08/2023
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