Healthcare Provider Details

I. General information

NPI: 1679464853
Provider Name (Legal Business Name): KARINA ANDREWSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5418 N EAGLE RD STE 102
BOISE ID
83713-0998
US

IV. Provider business mailing address

2102 W EVEREST LN STE 100
MERIDIAN ID
83646-7033
US

V. Phone/Fax

Practice location:
  • Phone: 208-580-7703
  • Fax:
Mailing address:
  • Phone: 208-505-4744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number9371858
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9371858
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: