OrganizationActive
Boise State University
NPI 1134905243 · Community Health Clinic/Center · Boise, ID
Provider details
- NPI number
- 1134905243
- Entity type
- Organization
- Primary specialty
- Community Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stephanie Hudon, Clinical Program Director(208) 995-3765
Specialties & taxonomies
Ambulatory Health Care Facilities
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Public Health or Welfare Agency251K00000X
Agencies
Practice location
2100 University Dr Ste 107
Boise, ID 83725-0001
Phone: (208) 426-1523
Fax: (208) 426-2302
Approximate (ZIP-level) locationGet directions
Mailing address
1910 University Dr
Boise, ID 83725
Other names (DBA / former)
- Doing business as
- Boise State University Public Health Clinic
- Doing business as
- Boise State University Public Health Clinic
Registry dates
- Enumerated
- 2023-09-05
- Last updated
- 2024-08-29
- Certified
- 2024-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.