NPI age
14 years
Enumerated 2012-02-29
● Active Type 2 · Organization
Subpart
Tennessee Phs Pc
Tennessee Phs Pc is 1 of 658 nurse practitioner organizations in Idaho.
Primary specialty
Nurse Practitioner
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Howard
Cfo
Last NPPES update
2014-07-02
Source: monthly bulk 2026-05
How this organization compares
Across 658 active nurse practitioner providers in Idaho.
NPI age
14 years
↑ 6 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-02Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
950 W. Bannock Street, Suite 1100
Boise, ID 837026140
Mailing address
1509 Dulles Drive
Lafayette, LA 70506
Authorized official
Nicole Howard
Cfo
📞 3379919276
Specialties
-
Nurse Practitioner Primary(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1063786648 |
Practice context
Single-site organization. Only one practice location on file.
Subpart of Provider Health Services Llc.
Provyx · Custom healthcare lists
Need all 658 Nurse Practitioner providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.