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TENNESSEE PHS PC
NPI 1063786648
Nurse Practitioner in Boise, ID

Active since February 29, 2012
950 W. BANNOCK STREET, SUITE 1100, BOISE, ID 83702(877) 260-4747(901) 261-4867 Get Directions Write a Review

NPPES record last updated: July 2, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tennessee Phs Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TENNESSEE PHS PC (NPI 1063786648) is a healthcare organization registered as a nurse practitioner in Boise, Idaho and active in the NPI registry since February 2012. The organization lists Nicole Howard, Cfo, as its authorized official.

NPPES Registry Identity

NPI1063786648
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameTENNESSEE PHS PC
Location Address950 W. BANNOCK STREET, SUITE 1100Boise, ID 83702-6140
Mailing Address1509 Dulles DriveLafayette, LA 70506 · (337) 991-9276 · Fax (337) 991-9288
Phone(877) 260-4747
Fax(901) 261-4867
Organization SubpartYesParent: Provider Health Services Llc
Authorized OfficialNicole HowardCfo · (337) 991-9276
Enumeration DateFebruary 29, 2012
Last NPPES UpdateJuly 2, 2014
✔ NPI 1063786648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(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 or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
950 W. BANNOCK STREET, Boise, ID 83702
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Other Identifiers 2

Medicare PIN20000842ID
Medicaid1063786648ID

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tennessee Phs PC's NPI number?

The NPI number for Tennessee Phs PC is 1063786648. It was assigned to this organization in the NPPES registry on February 29, 2012.

Where is Tennessee Phs PC located?

Tennessee Phs PC is located at 950 W. Bannock Street Suite 1100, Boise, ID 83702. The listed phone number is (877) 260-4747.

What is Tennessee Phs PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Tennessee Phs PC was last updated on July 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.