Healthcare Provider Details

I. General information

NPI: 1336006493
Provider Name (Legal Business Name): BRITTANY BLOCKMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 W HAYS ST
BOISE ID
83702-5028
US

IV. Provider business mailing address

1775 W STATE ST # 232
BOISE ID
83702-3924
US

V. Phone/Fax

Practice location:
  • Phone: 208-391-3182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY BLOCKMAN
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 917-687-9759