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

Revolutionary Medicine of Idaho

Organization Family Nurse Practitioner · NPI 1487493292

Revolutionary Medicine of Idaho is a Family Nurse Practitioner in Boise, Idaho. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

4776 N Five Mile Rd Ste 101
Boise, ID 83713-2715
Phone: (986) 777-0278
Fax: (208) 658-9501
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1487493292
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Robbins — Owner · (208) 871-0297
NPI enumeratedMay 21, 2024
Last updated in NPPESMay 21, 2024
Certification dateMay 21, 2024
Mailing address2536 Canyon Rd S, Melba, ID 83641-5258

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