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Individual

ROBERT TUCKER BOTKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
1075 E PARK BLVD, BOISE, ID 83712-7722
(208) 381-5970
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
73537
ID

Other

Enumeration date
08/06/2022
Last updated
10/14/2022
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