| Halcyon Infusions & Therapeutics, Pllc | |
|
1611 12th Ave Rd Ste A Nampa ID 83686-6182 | |
| (208) 546-3650 | |
| Not Available |
| Full Name | Halcyon Infusions & Therapeutics, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1611 12th Ave Rd Ste A, Nampa, Idaho |
| Authorized Official Name and Position | Matthew Fowler (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 2085463650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Halcyon Infusions & Therapeutics, Pllc 1123 12th Ave Rd # 325 Nampa ID 83686-5738 Ph: (208) 546-3650 | Halcyon Infusions & Therapeutics, Pllc 1611 12th Ave Rd Ste A Nampa ID 83686-6182 Ph: (208) 546-3650 |
| NPI Number | 1154188050 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154188050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
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