P Praxis·MD
● Active Type 1 · Individual

Cindy Jean Radavich, APRN

Nurse Practitioner·Dalton Gardens, ID· NPI 1295465011 · Enumerated 2022 · 3 years on NPI
Radavich is 1 of 1 nurse practitioner providers in Dalton Gardens and 1 of 79 in Idaho.
NPI age
3 years
Enumerated 2022-06-14
Primary specialty
Nurse Practitioner
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-06-14
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 79 active nurse practitioner providers in Idaho.

NPI age
3 years
↓ 4 yr below median (7 yr)
State licenses
1 state
12% of peers hold multiple states
Subspecialties
0
39% of peers hold subspecialties

NPI lifetime · 2022 → 2026

2022-06Enumerated in NPPES
2022 2026

Where they practice

Practice location
5920 N Govt Way Ste 2
Dalton Gardens, ID 838159200
📞 2086964462
Mailing address
5920 N Govt Way Ste 2
Dalton Gardens, ID 838159200
📞 2086964462

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    ID license #APRN-CNP54724 taxonomy 363LP2300X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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