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1104427152
CHRISTOPHER ALAN ANTHONY NICHOLAS
EAGLE, ID
NPI
1104427152
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: ID 66285)
Enumeration Date
2020-11-05
Last Update Date
2023-01-18
Business Address
CHRISTOPHER ALAN ANTHONY NICHOLAS
3101 E STATE ST
EAGLE, ID 83616-6232
Phone number: 208-473-3100
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Mailing Address
CHRISTOPHER ALAN ANTHONY NICHOLAS
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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