OrganizationActive
Idaho State University
NPI 1962095711 · Primary Care Nurse Practitioner · Meridian, ID
Provider details
- NPI number
- 1962095711
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Cynthia Rock, Clinics Director of Operations(208) 373-1743
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1311 E Central Dr
Meridian, ID 83642-7991
Phone: (208) 373-1734
Fax: (833) 499-1813
Approximate (ZIP-level) locationGet directions
Mailing address
1311 E Central Dr
Meridian, ID 83642-7991
Other names (DBA / former)
- Other name
- Isu Meridian Healthcare
Registry dates
- Enumerated
- 2021-02-12
- Last updated
- 2021-08-27
- Certified
- 2021-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.