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

Christopher Alan Anthony Nicholas

Individual provider Family Nurse Practitioner · NPI 1104427152

Christopher Alan Anthony Nicholas is a Nurse Practitioner in Eagle, Idaho. Qualified in 2020, 6 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
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Practice location Address checks out

3101 E State St
Eagle, ID 83616-6232
Phone: (208) 473-3100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1075 N Curtis Rd Ste 100, Boise, ID 83706-1348 — (208) 377-5166

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 66285 (ID)

Record details

NPI number1104427152
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 5, 2020
Last updated in NPPESJanuary 18, 2023
Certification dateJanuary 18, 2023
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Eagle