IndividualActive
Diana Green, DO
NPI 1639865207 · Pediatrics Physician · Boise, ID
Provider details
- NPI number
- 1639865207
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- License
- MRO-2255 (ID)
Practice location
8610 W Overland Rd
Boise, ID 83709-1645
Phone: (208) 954-8711
Fax: (208) 375-2217
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Registry dates
- Enumerated
- 2023-04-17
- Last updated
- 2023-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.