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General NPI Number Information
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NPI Number | 1902751423
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Entity Type | Individual
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Provider Name | JASON OAKES DALE OAKES FNP-C
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Gender | Male
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 512 N 21ST AVE
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City | CALDWELL
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State | ID
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Zip | 83605-4368
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Country | US
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Telephone | 208-985-1423
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Fax |
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Provider Business Mailing Address
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Address Line | 2364 SOUTHSIDE BLVD
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City | MELBA
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State | ID
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Zip | 83641-5041
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Country | US
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Telephone | 208-985-1423
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | N-40432
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License Number State | ID
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