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General NPI Number Information
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NPI Number | 1801175484
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Entity Type | Individual
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Provider Name | JEREMY SLOYER FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 800 W MAIN ST STE 1460
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City | BOISE
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State | ID
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Zip | 83702-5983
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Country | US
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Telephone | 949-298-0888
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Fax | 208-963-3302
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Provider Business Mailing Address
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Address Line | 800 W MAIN ST STE 1460
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City | BOISE
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State | ID
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Zip | 83702-5983
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Country | US
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Telephone | 949-298-0888
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Fax |
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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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 | 95011207
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 63182
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License Number State | ID
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