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

Keaton Nicholson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1902749864

Keaton Nicholson is a Student in an Organized Health Care Education/Training Program in Boise, Idaho. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

140 E Boise Ave
Boise, ID 83706-4302
Phone: (208) 385-9228
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1902749864
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedApril 13, 2026
Last updated in NPPESApril 13, 2026
Certification dateApril 13, 2026
Mailing address140 E Boise Ave, Boise, ID 83706-4302

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