Individual
MS. CYNTHIA M BOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7272 W POTOMAC DR, BOISE, ID 83704-9149
(208) 884-2922
(208) 463-3044
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3000
(208) 463-3079
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4874524-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
NP-1122A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750397238
—
ID
Enumeration date
08/01/2006
Last updated
04/08/2019
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