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

Mountain States Oncology Group

Organization Nurse Practitioner · NPI 1205093739

Mountain States Oncology Group is a Nurse Practitioner in Boise, Idaho. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

210 W Jefferson St
Boise, ID 83702-6044
Phone: (208) 343-3223
Fax: (208) 343-3263
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1205093739
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joni Sullivan — Business Administrator · (208) 343-3223
NPI enumeratedMay 21, 2008
Last updated in NPPESMay 21, 2008
Mailing addressPo Box 1809, Boise, ID 83701-1809

Other providers in Boise