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General NPI Number Information
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NPI Number | 1932727823
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Entity Type | Individual
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Provider Name | GABRIELLE I DYMENT NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1475 N COLE RD
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City | BOISE
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State | ID
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Zip | 83704-8537
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Country | US
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Telephone | 208-809-2880
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Fax | 208-809-2881
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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 | 208-955-6501
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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 | 54902
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 54902
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License Number State | ID
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