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NICOLE THURSTON, M.D., PLLC

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Company Details

Name: NICOLE THURSTON, M.D., PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 17 Jun 2008 (17 years ago)
Financial Date End: 30 Jun 2013
Date dissolved: 10 Sep 2013
Entity Number: 236148
Place of Formation: IDAHO
File Number: 0000236148
ZIP code: 83712
County: Ada County
Principal Address: 100 E IDAHO BOISE, ID 83712

National Provider Identifier

NPI Number:
1336394394

Authorized Person:

Name:
TRICIA STERLING
Role:
REIMBURSMENT SUPERVISOR
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
2083231905

Filing

Filing Name Filing Number Filing date
Annual Report 0001874774 2012-07-24
Annual Report 0001874773 2011-06-17
Annual Report 0001874772 2010-05-05
Annual Report 0001874771 2009-06-03
Initial Filing 0000236148 2008-06-17

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Date of last update: 24 Sep 2024

Sources: Idaho Secretary of State