Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Revolutionary Medicine of Idaho

Organization Family Nurse Practitioner · NPI 1487493292

Revolutionary Medicine of Idaho provides Family Nurse Practitioner services in Boise, Idaho. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

4776 N Five Mile Rd Ste 101
Boise, ID 83713-2715
Phone: (986) 777-0278
Fax: (208) 658-9501
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1487493292
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Robbins — Owner · (208) 871-0297
NPI enumeratedMay 21, 2024
Last updated in NPPESMay 21, 2024
Certification dateMay 21, 2024
Mailing address2536 Canyon Rd S, Melba, ID 83641-5258

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