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General NPI Number Information
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NPI Number | 1336378124
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Entity Type | Individual
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Provider Name | THOR HAUFF FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 4971 W OVERLAND RD
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City | BOISE
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State | ID
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Zip | 83705-2822
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Country | US
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Telephone | 208-472-5050
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Fax | 208-472-5051
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Provider Business Mailing Address
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Address Line | PO BOX 191050
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City | BOISE
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State | ID
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Zip | 83719-1050
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Country | US
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Telephone | 208-955-6500
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Fax | 208-955-6503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1160A
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | N-26795
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License Number State | ID
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