MR. BRENNEN PHAN RN
NPI 1619861382
Registered Nurse in Boise, ID

Active since June 05, 2025
190 E BANNOCK ST, BOISE, ID 83712(208) 706-5850 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mr. Brennen Phan Rn NPPES

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

MR. BRENNEN PHAN RN (NPI 1619861382) is an individual registered nurse in Boise, Idaho, licensed in Idaho (73136) and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1619861382
Entity TypeIndividualMale
Primary Taxonomy163W00000X
Provider Legal NameMR. BRENNEN PHANCredential: RN
Location Address190 E BANNOCK STBoise, ID 83712-6241
Mailing Address1850 S Pelican AveMeridian, ID 83642-4747 · (208) 794-2175
Sole ProprietorNo
Enumeration DateJune 5, 2025
NPPES CertifiedJune 5, 2025
✔ NPI 1619861382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in ID · 73136
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
190 E BANNOCK ST, Boise, ID 83712

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Neonatal, Critical Care)
190 E BANNOCK ST
BOISE, ID 83712
Physical Therapist
190 E BANNOCK ST
BOISE, ID 83712
Nurse Practitioner
190 E BANNOCK ST
BOISE, ID 83712
Occupational Therapist (Feeding, Eating & Swallowing)
190 E BANNOCK ST
BOISE, ID 83712
Nurse Practitioner (Acute Care)
190 E BANNOCK ST
BOISE, ID 83712
Nurse Anesthetist, Certified Registered
190 E BANNOCK ST
BOISE, ID 83712
Internal Medicine
190 E BANNOCK ST
BOISE, ID 83712
Pediatrics
190 E BANNOCK ST
BOISE, ID 83712

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 Brennen Phan's NPI number?

The NPI number for Brennen Phan is 1619861382. It was assigned to this individual provider in the NPPES registry on June 5, 2025.

Where is Brennen Phan located?

Brennen Phan practices at 190 E Bannock St, Boise, ID 83712. The listed phone number is (208) 706-5850.

What is Brennen Phan's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

When was this NPI record last updated?

The NPPES record for Brennen Phan was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.