IndividualActive
Tyson Harris, NP
NPI 1588905699 · Adult Health Nurse Practitioner · Blackfoot, ID
Provider details
- NPI number
- 1588905699
- Entity type
- Individual
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Male
- Sole proprietor
- No
- License
- AP60641080 (WA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
98 Poplar St
Blackfoot, ID 83221-1758
Phone: (208) 239-8033
Fax: (208) 785-9450
Approximate (ZIP-level) locationGet directions
Mailing address
98 Poplar St
Blackfoot, ID 83221-1758
Registry dates
- Enumerated
- 2013-03-14
- Last updated
- 2025-05-22
- Certified
- 2025-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.