Individual
WILLIAM ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN NP-C
Contact information
Practice address
1148 S BLANCA AVE, BOISE, ID 83709-1112
(208) 871-4548
Mailing address
1148 S BLANCA AVE, BOISE, ID 83709-1112
(208) 871-4548
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N-37637
ID
363LP2300X
Primary Care Nurse Practitioner
Primary
55489
ID
Other
Enumeration date
03/23/2016
Last updated
03/28/2017
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