Healthcare Provider Details

I. General information

NPI: 1427315548
Provider Name (Legal Business Name): BRITTANY BLOCKMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
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: 208-252-7676
Mailing address:
  • Phone: 208-391-3182
  • Fax: 208-252-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM-15132
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: