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

Individual provider Pediatric Nurse Practitioner · NPI 1770204521

Rachel Elledge, CPNP-PC is a Nurse Practitioner in Boise, Idaho. Qualified in 2022, 4 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
4
Licensed in
ID
In the registry since
2022
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Practice location Address checks out

305 E Jefferson St
Boise, ID 83712-6231
Phone: (208) 381-6196
Fax: (208) 381-6199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 55305 (ID)

Record details

NPI number1770204521
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP-PC
Sole proprietorNo
NPI enumeratedSeptember 9, 2022
Last updated in NPPESOctober 26, 2022
Certification dateOctober 26, 2022
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 2022 (4 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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