Maxwell, Nicole Marie

Maxwell, Nicole Marie is an individual health care provider with primary practice located at 4219 W Emerald St , Boise ID 83706-2036. She recently has only one registered license in Other Service Providers / Naturopath, which is considered as her primary health care specialty. Maxwell, Nicole Marie can be contacted via phone (208) 338-0405.

Contact Information

Primary practice address
4219 W Emerald St Boise ID 83706-2036
Fax: (208) 422-9957
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X NT00001153 Washington

Profile Details

NPI number 1083772065
LBN Legal business name Maxwell, Nicole Marie
Credentials NMD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
Last updated Jan 28th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083772065 NPPES
Washington Other 201450836 TAX IDENTIFICATION NUMBER

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