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

Cody Johanna Bonine, FNP

Individual provider Family Nurse Practitioner · NPI 1528730165

Cody Johanna Bonine, FNP is a Nurse Practitioner in Eagle, Idaho. Qualified in 2021, 5 years ago. Practices with Key Stone Health Care, a 6-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2021
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

21 N Fisher Park Way
Eagle, ID 83616-4796
Phone: (208) 996-8181
Fax: (208) 549-7880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 69928 (ID)

Record details

NPI number1528730165
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorYes
NPI enumeratedOctober 1, 2021
Last updated in NPPESOctober 1, 2021
Certification dateSeptember 26, 2021

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 Key Stone Health Care — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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