Individual
MATTHEW HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1775 W STATE ST, BOISE, ID 83702-3924
(208) 859-1164
Mailing address
1775 W STATE ST, BOISE, ID 83702-3924
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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