Active NPI
Lynnan Nielson, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Boise, ID
National Provider Identifier
1013339415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- P6882
- Practice address
- 10255 W Overland Rd
Boise, ID 83709-1430 - Phone
- (208) 367-7205
- NPI assigned
- Jan 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | P6882 | ID | Primary |
Addresses
Primary practice location
10255 W Overland Rd
Boise, ID 83709-1430
Mailing address
10255 W Overland Rd
Boise, ID 83709-1430
Phone (208) 367-7205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P6882 | ID | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390176000000",
"number": "1013339415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10255 W OVERLAND RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837091430",
"telephone_number": "208-367-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10255 W OVERLAND RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837091430",
"telephone_number": "208-367-7205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSON",
"first_name": "LYNNAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-20",
"last_updated": "2014-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "ID",
"license": "P6882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.