Individual
MICHAEL BRYAN LOEGERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
413 ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 323-1125
(208) 323-9604
Mailing address
413 ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 323-1125
(208) 323-9604
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP727A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807460100
—
ID
Enumeration date
06/07/2006
Last updated
04/16/2021
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