Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Christopher Alan Anthony Nicholas

Individual provider Family Nurse Practitioner · NPI 1104427152

Christopher Alan Anthony Nicholas is a Nurse Practitioner in Eagle, Idaho. Qualified in 2020, 6 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
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Practice location Address checks out

3101 E State St
Eagle, ID 83616-6232
Phone: (208) 473-3100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1075 N Curtis Rd Ste 100, Boise, ID 83706-1348 — (208) 377-5166

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 66285 (ID)

Record details

NPI number1104427152
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 5, 2020
Last updated in NPPESJanuary 18, 2023
Certification dateJanuary 18, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Eagle