IndividualActive
Joseph Ronquillo, DNP
NPI 1902591399 · Pediatric Nurse Practitioner · Boise, ID
Provider details
- NPI number
- 1902591399
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- DNP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 75784 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2222
Fax: (208) 381-7170
Approximate (ZIP-level) locationGet directions
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Registry dates
- Enumerated
- 2023-04-10
- Last updated
- 2023-09-18
- Certified
- 2023-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.