Individual provider · Type 1 NPI

Hyrum Davenport, NP

Nurse Practitioner · Chubbuck, ID

NPI number 1255567210 Active

Practice location

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Call (208) 252-5621 Map

Fax (208) 648-4167

Mailing address

PO Box 2516
Pocatello, ID 83206-2516

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNP-913A (ID)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1255567210

Hyrum Davenport, NP's National Provider Identifier is 1255567210, issued on Jun 4, 2009. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Chubbuck, ID. The record was last updated on Sep 23, 2025.