Healthcare Provider Details

I. General information

NPI: 1518508506
Provider Name (Legal Business Name): RENEE ZUBIN PARSONS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10255 W OVERLAND RD
BOISE ID
83709-1430
US

IV. Provider business mailing address

740 S WOODRUFF AVE
IDAHO FALLS ID
83401-5285
US

V. Phone/Fax

Practice location:
  • Phone: 208-302-5600
  • Fax: 208-302-5655
Mailing address:
  • Phone: 208-542-9111
  • Fax: 85-429-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201908773NP-PP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number62839
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: