IndividualActive
Elizabeth Black, MD
NPI 1043697113 · Pediatric Nephrology Physician · Boise, ID
Provider details
- NPI number
- 1043697113
- Entity type
- Individual
- Primary specialty
- Pediatric Nephrology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- A151555 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Student, Health Care
Allopathic & Osteopathic Physicians
Practice location
305 E Jefferson St
Boise, ID 83712-6231
Phone: (208) 381-7336
Fax: (208) 381-7495
Approximate (ZIP-level) locationGet directions
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Additional practice locations (1)
- 726 N Medical Center Dr E Ste 209Clovis, CA 93611-6886Phone: (559) 325-5656Fax: (559) 325-5568
Registry dates
- Enumerated
- 2015-04-28
- Last updated
- 2026-06-03
- Certified
- 2026-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.