IndividualActive
Nurudeen Ibrahim, NP
NPI 1417655713 · Gerontology Nurse Practitioner · Boise, ID
Provider details
- NPI number
- 1417655713
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Male
- Sole proprietor
- No
- License
- 75389 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone: (208) 302-2600
Fax: (208) 302-2625
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 190930
Boise, ID 83719-0930
Additional practice locations (1)
- 133 S Baraya WayMeridian, ID 83642-5408Phone: (208) 867-6801
Registry dates
- Enumerated
- 2023-02-16
- Last updated
- 2023-06-02
- Certified
- 2023-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.