Individual provider · Type 1 NPI

Elmer G. Dodge Jr., FNP

Nurse Practitioner · Star, ID

NPI number 1508918236 Active

Practice location

9858 W State St
Star, ID 83669-5210

Call (208) 286-0666 Map

Fax (208) 286-0565

Mailing address

PO Box 44267
Boise, ID 83711-0267

Specialties and licenses

TaxonomyCodeLicense
General Practice Registered Nurse 163WG0000XNP534A (ID)
Nurse Practitioner Primary 363L00000XNP-534A (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…

5 other providers at this address

Other nurse practitioner providers in Star

See all in Star →

About NPI 1508918236

Elmer G. Dodge Jr., FNP's National Provider Identifier is 1508918236, issued on Jan 16, 2007. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Star, ID. The record was last updated on Sep 1, 2020.