Individual
JAMES MASAYOSHI MIYAZAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
315 E ELM, STE 100, CALDWELL, ID 83605
(208) 367-5171
(208) 367-5180
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5171
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19119
CA
363LF0000X
Family Nurse Practitioner
NP1526A
ID
363LN0000X
Neonatal Nurse Practitioner
19119
CA
363LN0005X
Critical Care Neonatal Nurse Practitioner
19119
CA
Other
Enumeration date
08/26/2010
Last updated
10/01/2015
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