Slavik Osipchuk, NP
in Boise, ID. Individual provider (NPI-1).
NPI number1164043162
StatusActive
Last updated in NPPESJan 14, 2025
Details
- NPI
- 1164043162
- Entity type
- Individual (NPI-1)
- Name
- Slavik Osipchuk
- Credential
- NP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 30, 2020
- Certification date
- Jan 14, 2025
- Last updated
- Jan 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0000X | 62202 | ID | Yes | |
| 363L00000X | Nurse Practitioner | 62202 | ID |
Other names
- Vyacheslav Osipchuk (Former Name)
Practice location
987 S Allante PlBoise, ID 83709-1612
Phone 208-947-7246 · Fax 208-297-7772
Mailing address
987 S Allante PlBoise, ID 83709-1612
Phone 208-947-7246 · Fax 208-297-7772
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