Tyler Jue
Nurse Practitioner - Gerontology
1055 N Curtis Rd # S6
Boise
, Idaho 83706-1309
Tyler Jue
Nurse Practitioner - Gerontology
1055 N Curtis Rd # S6
Boise
, Idaho 83706-1309
(208) 302-0855
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Tyler Jue
- 3340 E Goldstone Way
- Meridian, ID
- Zip : 83642-1026
- Fax : (208) 302-0855
- Phone : (208) 302-0800
Second Address
- Tyler Jue
- 1055 N Curtis Rd # S6
- Boise, ID
- Zip : 83706-1309
- Fax : (208) 302-0855
- Phone : (208) 302-0800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 55104 | ID |
National Provider Identifier
| NPI | 1033641154 |
|---|---|
| Provider Name | Tyler Jue |
| First Address | Meridian, ID 83642-1026 |
| Second Address | Boise, ID 83706-1309 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/03/2017 |
| Last Update Date | 05/04/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.