Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mmmedical Group LLC

Organization Nurse Practitioner · NPI 1548890460

Mmmedical Group LLC is a Nurse Practitioner in Boise, Idaho. Works from 2 locations. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

801 N Stilson Rd Ste 300
Boise, ID 83703-5145
Phone: (208) 332-4540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9858 W State St, Star, ID 83669-5210 — (208) 286-9471

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1548890460
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Randy Evaro — President · (208) 333-0000
NPI enumeratedJanuary 20, 2020
Last updated in NPPESSeptember 23, 2020
Certification dateSeptember 23, 2020
Mailing addressPo Box 5328, Boise, ID 83705-0328

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