Individual provider · NPI-1

Niculina Bistriceanu, MSN

Nurse Practitioner, Family · Nampa, ID

NPI number1184197311

StatusActive

Last updated in NPPESFeb 5, 2021

Details

NPI: 1184197311
Entity type: Individual (NPI-1)
Name: Niculina Bistriceanu
Credential: MSN
Sex: Female
Sole proprietor: No
Enumeration date: Jan 10, 2019
Certification date: Feb 5, 2021
Last updated: Feb 5, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	64875	ID	Yes
163WG0000X	Registered Nurse, General Practice	38220	ID
363L00000X	Nurse Practitioner	64875	ID

Practice location

7615 Madden Dr
Nampa, ID 83686-9425

Phone 208-440-1085

Mailing address

7615 Madden Dr
Nampa, ID 83686-9425

Phone 208-440-1085

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