Individual
ROBERTA J. BOSTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
765 S UTAH AVE, IDAHO FALLS, ID 83402-5093
(208) 525-2600
Mailing address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2700
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
12751401-4405
UT
363LA2100X
Acute Care Nurse Practitioner
68854
ID
Other
Enumeration date
10/01/2021
Last updated
09/12/2023
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