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NPI Code Detail

MEDICARE: LILLY BOYER

MEDICARE: LILLY BOYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianID

General Provider Information

NPI Number : 1588500714
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLY BOYER
Provider Business Mailing Address
First Line : 1905 S TOPAZ WAY STE 100
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-4112
Country : US
Telephone Number : 208-518-0870
Fax Number :
Provider Business Practice Location Address
First Line : 1905 S TOPAZ WAY STE 100
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-4112
Country : US
Telephone Number : 208-518-0870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2026
Last Update Date : 04/29/2026

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Directions to “ LILLY BOYER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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