Individual provider · Type 1 NPI

Samantha Tully, NP

Family Nurse Practitioner · Boise, ID

NPI number 1265320105 Active

Practice location

190 E Bannock St
Boise, ID 83712-6241

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	5671261 (ID)

Family Nurse Practitioner: Definition to come...

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About NPI 1265320105

Samantha Tully, NP's National Provider Identifier is 1265320105, issued on Jun 27, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Boise, ID. The record was last updated on Jul 11, 2025.