Individual
AARON DYKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 COTTONWOOD CT STE 150, EAGLE, ID 83616-6550
(208) 260-5431
Mailing address
100 COTTONWOOD CT STE 150, EAGLE, ID 83616-6550
(208) 260-5431
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
201703051
OR
363LP0200X
Pediatric Nurse Practitioner
Primary
55392
ID
Other
Enumeration date
09/08/2014
Last updated
01/19/2023
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