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Individual

PETER ADOLPHSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC, RN, DNP

Contact information

Practice address
3749 S MILL SITE LN STE G, BOISE, ID 83716-5599
(803) 917-2923
Mailing address
3749 S MILL SITE LN STE G, BOISE, ID 83716-5599
(803) 917-2923

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6045
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4671295
ID

Other

Enumeration date
01/26/2015
Last updated
02/05/2026
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