IndividualActive
Mary Derlacki, FNP
NPI 1609947431 · Rheumatology Physician · Boise, ID
Provider details
- NPI number
- 1609947431
- Entity type
- Individual
- Primary specialty
- Rheumatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- License
- 69483 (ID)
Practice location
2800 W Overland Rd
Boise, ID 83705-3038
Phone: (208) 801-1414
Fax: (208) 207-2866
Mailing address
1707 N 19th St
Boise, ID 83702-0706
Registry dates
- Enumerated
- 2006-11-13
- Last updated
- 2024-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.