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General NPI Number Information
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NPI Number | 1841120870
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Entity Type | Individual
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Provider Name | MICHAEL LOGAN STANDLEY
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Gender | Male
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Dates
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Enumeration Date | 05/21/2026
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Last Update Date | 05/21/2026
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Provider Practice Location Address
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Address Line | 5080 E COMMERCE ST
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City | NAMPA
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State | ID
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Zip | 83687-5513
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Country | US
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Telephone | 208-489-1900
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Fax | 208-489-1900
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Provider Business Mailing Address
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Address Line | 5083 E COMMERCE AVE
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City | NAMPA
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State | ID
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Zip | 83687
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Country | US
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Telephone | 208-489-1900
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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 | 163WG0100X
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Taxonomy Name | Gastroenterology Registered Nurse
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License Number | 55316
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License Number State | ID
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