Individual
CHARLES BRYAN SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
267 N CANYON DR, GOODING, ID 83330-5500
(208) 934-4433
Mailing address
9891 W MREN ST, BOISE, ID 83709-4723
(208) 484-7804
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
16540
ID
163W00000X
Registered Nurse
44491
ID
163WF0300X
Flight Registered Nurse
44491
ID
363L00000X
Nurse Practitioner
Primary
66241
ID
363LF0000X
Family Nurse Practitioner
226070
MT
363LF0000X
Family Nurse Practitioner
66241
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/04/2020
Last updated
08/29/2024
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