EAST BOISE COUNTY MEDICAL CLINIC (NPI# 1255608238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255608238 |
| Entity Type | Organization |
| Organization Name | EAST BOISE COUNTY MEDICAL CLINIC |
| Practice Address |
3852 Highway 21 Boise ID 83716 |
| Practice Telephone | 2083924544 |
| Practice Fax Number | 2083924128 |
| Mailing Telephone | 2083924544 |
| Mailing Fax Number | 2083924128 |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2011-11-19 |
| Authorized Official Name | LYNDA JOANNE MARICLE-KUWAHARA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2083924544 |
| Authorized Official Credential | APRN-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3852 HIGHWAY 21 |
| City | BOISE |
| State | ID |
| Zip Code | 83716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790294973 | The Pt Next Door | Clinic/Center | 6098 E. Grand Prairie Drive, Boise, ID 83716 | 2017-09-20 |
| 1326577610 | Koreen Boydstun | Specialist/Technologist | 3301 Sweetwater Dr, Boise, ID 83716 | 2017-06-08 |
| 1558806117 | Katie Palmer | Behavioral Analyst | 2939 S Shadywood Way, Boise, ID 83716 | 2017-01-05 |
| 1245680099 | Elaine Key Md Pllc | Anesthesiology | 3919 E Timbersaw Dr, Boise, ID 83716 | 2016-06-13 |
| 1174993463 | Daria Elizabeth Karas | Physician Assistant | 8000 S. Federal Way, Boise, ID 83716 | 2015-09-30 |
| 1407239973 | Humangood Idaho | Skilled Nursing Facility | 5301 E Warm Springs Ave, Boise, ID 83716 | 2015-07-02 |
| 1225460066 | Katherine Elizabeth Turnbull | Nurse Practitioner | 2051a E Summersweet Dr, Boise, ID 83716 | 2013-08-03 |
| 1134483845 | Karen D Lodge | Pharmacist | 5211 S Farmhouse Pl, Boise, ID 83716 | 2012-06-27 |
| 1730341827 | Christopher A Thomason | Dentist | 5898 S Quamash Way, Boise, ID 83716 | 2008-06-30 |
| 1861515637 | Tyler John Harrington | Dentist | 2033 E Summersweet Dr, Boise, ID 83716 | 2007-04-09 |
| Find all providers in zip 83716 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1588277529 | Tauna Marie Young | Nurse Practitioner | 1681 S Kimball Way, Boise, ID 83709-1654 | 2020-08-28 |
| 1497367114 | Lindsay Ruggles | Nurse Practitioner | 1105 S Federal Way, Boise, ID 83705-2546 | 2020-08-24 |
| 1265056014 | Brynn Crisp | Nurse Practitioner | 1075 N Curtis Rd Ste 100, Boise, ID 83706-1348 | 2020-06-07 |
| 1518592674 | Amber Lynn Gillette | Nurse Practitioner | 1111 S Orchard St Ste 251, Boise, ID 83705-1964 | 2020-03-10 |
| 1265062806 | Jamie Watts | Nurse Practitioner | 5353 W Hill Rd, Boise, ID 83703-2943 | 2020-01-23 |
| 1730654435 | Melissa Gaffrey | Nurse Practitioner | 500 S 8th St, Boise, ID 83702-7107 | 2018-10-09 |
| 1659876399 | Dixie Jean Skinner | Nurse Practitioner | 10583 W. Lake Hazel Rd., Boise, ID 83709-8370 | 2018-03-26 |
| 1063912202 | Devon Moser | Nurse Practitioner | 901 N Curtis Rd Ste 100, Boise, ID 83706-1339 | 2018-02-14 |
| Find all providers in BOISE | ||||
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| 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.