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1720715998
ROBERT TUCKER BOTKIN
BOISE, ID
NPI
1720715998
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ID 73537)
Enumeration Date
2022-08-06
Last Update Date
2022-10-14
Business Address
ROBERT TUCKER BOTKIN PMHNP
1075 E PARK BLVD
BOISE, ID 83712-7722
Phone number: 208-381-5970
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Mailing Address
ROBERT TUCKER BOTKIN PMHNP
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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