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

Cassie Nicole Wilson, AGCANP

Individual provider Nurse Practitioner · NPI 1104573112

Cassie Nicole Wilson, AGCANP is a Nurse Practitioner in Boise, Idaho. Qualified in 2021, 5 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2022
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Practice location Address checks out

1075 N Curtis Rd Ste 101
Boise, ID 83706-1348
Phone: (208) 302-2800
Fax: (208) 302-2825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1055 N Curtis Rd, Boise, ID 83706-1309 — (208) 367-2121

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 66379 (ID)

Record details

NPI number1104573112
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGCANP
Sole proprietorNo
NPI enumeratedMarch 9, 2022
Last updated in NPPESSeptember 13, 2024
Certification dateSeptember 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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