OrganizationActive
Childrens Kidney Specialists PLLC
NPI 1700088002 · Pediatric Nephrology Physician · Boise, ID
Provider details
- NPI number
- 1700088002
- Entity type
- Organization
- Primary specialty
- Pediatric Nephrology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Randall Jenkins, Doctor(208) 381-7336
- License
- M6943 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
100 E Idaho St
200
Boise, ID 83712-6223
Phone: (208) 381-7336
Fax: (208) 381-7495
Approximate (ZIP-level) locationGet directions
Mailing address
1935 Nw Norfolk Ct
Portland, OR 97229-8448
Registry dates
- Enumerated
- 2007-05-31
- Last updated
- 2012-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.