Becky Bole, ANP, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Nampa, ID
NPI 1043621576 · NPPES record last updated Sep 5, 2025
Key facts
- NPI
- 1043621576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 62791 (ID)
- Practice address
- 824 17TH Ave S Ste 5
Nampa, ID 83651-4781 - Phone
- (208) 918-2675
- Fax
- (208) 918-8627
- NPI assigned
- May 19, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
824 17TH Ave S
Suite 10
Nampa, ID 83651-4781
Phone (208) 918-2675
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191121002661 | ID | Practitioner - Nurse Practitioner | 5294951687 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62791 | ID | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolving Minds Mental Health | Psychiatric/Mental Health | Current |
Accepting new patients |
| Meridian Advanced Psychiatry , LLC | Current |
Accepting new patients |
Locations
211 E Logan St
Ste 301
Caldwell, ID 83605
951 E Plaza Dr
Ste 110
Eagle, ID 83616
Phone (208) 274-9580
1672 S Woodsage Ave
Ste 120
Meridian, ID 83642
Phone (208) 515-2273
824 17th Ave S
Ste 5
Nampa, ID 83651
Phone (208) 901-9274
824 17th Ave S
Ste 10
Nampa, ID 83651
Phone (208) 918-2675
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 62791 | ID | Yes |
Addresses
Primary practice location
824 17TH Ave S Ste 5
Nampa, ID 83651-4781
Mailing address
824 17TH Ave S Ste 5
Nampa, ID 83651-4781
Phone (208) 918-2675
Other providers in Nampa, ID
- Valentyna Bohatyrets
- Megan Bohlen
- Boise Endoscopy Center, LLC
- Boisvert, Inc.
- Jose Miguel Bolanos Rivera
- Jennifer Catherine Bolin
- Page Bolinske
- Rachelle E Bond
- Anthony Ray Book
- Cassidy Marie Book
All providers in Nampa, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.