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

ELMER G DODGE JR., FNP

Active

ELMER G DODGE JR., FNP is a Nurse Practitioner healthcare provider located in STAR, Idaho. NPI 1508918236 is currently active in the NPPES registry. Verify at CMS.

Nurse Practitioner · STAR, ID

Registration Details

NPI Number
1508918236
Provider Type
Individual
Gender
Male
NPI Issued
Jan 16, 2007 (19.572206737583 yrs)
Last Updated
Sep 1, 2020
Licenses
NP534A (ID)
NP-534A (ID)

Practice Information

Address
9858 W STATE ST
STAR, ID, 836695210
Browse ID providers · Browse ZIP 83669
Phone
2082860666
Fax
2082860565
Primary Specialty
Nurse Practitioner
363L00000X
Additional Specialty
Nurse Practitioner

Other Nurse Practitioner Providers in STAR, ID

Name Credential NPI
KAYLA MARIE WOODS FNP-C 1740009232
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.