IndividualActive
Nicholas Blickenstaff, M.D., M.S.
NPI 1437544582 · Dermatology Physician · Boise, ID
Provider details
- NPI number
- 1437544582
- Entity type
- Individual
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., M.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 036.150002 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
6454 W Emerald St
Boise, ID 83704-8734
Phone: (208) 377-0820
Fax: (208) 375-8046
Approximate (ZIP-level) locationGet directions
Mailing address
7123 W Archer Ave
Chicago, IL 60638-2203
Additional practice locations (1)
- 13176 W Persimmon LnBoise, ID 83713-5063Phone: (208) 939-8640Fax: (208) 939-1892
Registry dates
- Enumerated
- 2015-04-04
- Last updated
- 2022-04-25
- Certified
- 2022-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.