Individual provider · Type 1 NPI
Michael Philip Abracosa Gilliam, CPNP
Pediatric Nurse Practitioner · Nampa, ID
NPI number
1487587481
Active
Practice location
9850 W St Lukes Dr
Nampa, ID 83687-7912
Fax (208) 205-7822
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 5481515 (ID) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1487587481
Michael Philip Abracosa Gilliam, CPNP's National Provider Identifier is 1487587481, issued on Jun 8, 2026. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Nampa, ID. The record was last updated on Oct 6, 2026.