DR. LEONA JO'ANNE' CHURCH


Address: 1655 W Fairview Ave Ste 206, Boise, ID 83702-5190
Phone: 2083950000

DR. LEONA JO'ANNE' CHURCH (NPI# 1073675617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073675617
Entity Type Individual
Full Name DR. LEONA JO'ANNE' CHURCH
Credential CPNP
Practice Address 1655 W Fairview Ave Ste 206
Boise
ID 83702-5190
Practice Telephone 2083950000
Practice Fax Number 2083950009
Mailing Telephone 2083950000
Mailing Fax Number 2083950009
Enumeration Date 2006-12-13
Last Update Date 2009-04-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
NP-157A ID Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
ID 805703400 05

Office Location

Street Address 1655 W FAIRVIEW AVE STE 206
City BOISE
State ID
Zip Code 83702-5190

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144382797 North End Children's Health Clinic Clinic/Center 1655 W Fairview Ave Ste 206, Boise, ID 83702-5190 2006-12-13

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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356959100 Taylor Frances Mello Nurse Practitioner 2770 N Woodview Pl, Boise, ID 83702-6541 2020-07-17
1275192205 Luna Hodges Nurse Practitioner 125 E Idaho St Ste 200, Boise, ID 83712-6225 2019-06-12
1386204758 Aimee Lynn Hastriter Nurse Practitioner 125 E Idaho St Ste 200, Boise, ID 83712-6225 2019-06-18
1659844066 Rachel Bentley Nurse Practitioner 1072 N Liberty St Ste 200, Boise, ID 83704-8963 2019-01-08
1760845259 Jill Moughamian Nurse Practitioner 4700 N Cloverdale Rd Ste 103, Boise, ID 83713-1067 2016-04-01
1326388653 Mitzi M Cieslak Nurse Practitioner 100 E Idaho St, Ste 200, Boise, ID 83712-6267 2013-02-23
1083977391 Dawn L Powell Nurse Practitioner 610 W Hays St, Boise, ID 83702-5511 2012-06-21
1437467644 Jaeger A Ashton Nurse Practitioner 305 E Jefferson St, Boise, ID 83712-6273 2010-09-22
1619158144 Margaret A Henbest Nurse Practitioner 190 E Bannock St, Boise, ID 83712-6241 2007-11-27
1811184492 Alisa D. Ortega Nurse Practitioner 417 S 6th St, Boise, ID 83702-7632 2007-09-27
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Competitor

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City BOISE
Zip Code 83702

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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