DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

FARDIN WALIZAY

Active Sole Proprietor

Community Health Worker · BOISE, ID

Registration Details

NPI Number
1407710593
Provider Type
Individual
Gender
Male
NPI Issued
Dec 12, 2025 (0.35850064723434 yrs)
Last Updated
Dec 12, 2025
Sole Proprietor
Yes

Practice Information

Address
275 N LIBERTY ST
BOISE, ID, 837049331
Browse ID providers · Browse ZIP 83704
Phone
2088012918
Primary Specialty
Community Health Worker
172V00000X

Other Community Health Worker Providers in BOISE, ID

Name Credential NPI
KIMBERLEE BRANT LPN LMT 1285027672
RUSSELL ADAM MONTGOMERY BA 1861269383
TAMMIE HAYNES BA 1407623598
MS. TAMY JO MURKLE BA, MA 1699535260
JESLYN MASHELL NEES BS, MA 1922868694
TYLAR KELTY 1750141966
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.