Church, Nathan John

Church, Nathan John is an individual health care provider with primary practice located at 6052 W State St , Boise ID 83703-2739. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Church, Nathan John can be contacted via phone (208) 344-7799.

Contact Information

Primary practice address
6052 W State St Boise ID 83703-2739
Phone: (208) 344-7799
Fax: (208) 344-7152
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-266 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-266 Idaho

Profile Details

NPI number 1386635977
LBN Legal business name Church, Nathan John
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Nov 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386635977 NPPES
Idaho Other PA-266 STATE LISCENSE
Idaho Other PA00678 STATE LISCENSE

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