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Elmer G Dodge JR., FNP
Nurse Practitioner in Star, Idaho
NPI 1508918236

Elmer G Dodge JR. is a Nurse Practitioner based in Boise, ID. Elmer G Dodge JR. practices in Star, ID and has the professional credentials of FNP. The NPI Number for Elmer G Dodge JR. is 1508918236 and holds a License No. NP534A (Idaho).

The current practice location address for Elmer G Dodge JR. is 9858 W State St, Star, ID and can be reached out via phone at 208-286-0666 and via fax at 208-286-0565. You can also correspond with Elmer G Dodge JR. through the mailing address at PO BOX 44267, BOISE, ID - 83711-0267 (mailing address contact number: 208-286-0666).

Location: 9858 W State St, Star, ID, 83711-0267
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508918236
Provider Name
Elmer G Dodge JR.
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
9858 W State St, Star, ID, 83711-0267
Phone Number
208-286-0666
Fax Number
208-286-0565
Provider Enumeration Date
01/16/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NPQP7 01 ID BLUE CROSS OF IDAHO
000010150031 01 ID REGENCE BLUE SHIELD OF ID
806045400 05 ID
institution
Provider Business Practice Location Address Details
Address
9858 W State St
City
Star
State
Idaho
Zip
83669-5210
Phone Number
208-286-0666
Fax Number
208-286-0565
person
Provider Business Mailing Address Details
Address
9858 W State St
City
Star
State
Idaho
Zip
83669-5210
Phone Number
208-286-0666
Fax Number
208-286-0565
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
General Practice
Taxonomy
163WG0000X
License No.
NP-534A (Idaho)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
NP534A (Idaho)
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.
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institution
Star Medical Center Pc
NPI 1508918244
Nurse Practitioner
9858 W State St,
STAR, ID
83669-5210
208-286-0666
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