Provider Demographics
NPI:1730311564
Name:THOMASON, AARON L (NP)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:L
Last Name:THOMASON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8675 W ARDENE ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-2601
Mailing Address - Country:US
Mailing Address - Phone:208-780-3900
Mailing Address - Fax:208-375-2882
Practice Address - Street 1:8675 W ARDENE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-2601
Practice Address - Country:US
Practice Address - Phone:087-803-9002
Practice Address - Fax:208-375-2882
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60100852363L00000X
IDNP-1305A363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1730311564Medicaid