IndividualActive
Jacob Stoddard, APRN-CNP
NPI 1174464929 · Primary Care Nurse Practitioner · Idaho Falls, ID
Provider details
- NPI number
- 1174464929
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN-CNP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 5381502 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2455 Blue Camas Way
Idaho Falls, ID 83402-3849
Phone: (208) 242-8036
Approximate (ZIP-level) locationGet directions
Mailing address
2455 Blue Camas Way
Idaho Falls, ID 83402-3849
Registry dates
- Enumerated
- 2026-04-04
- Last updated
- 2026-04-04
- Certified
- 2026-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.