CARLIE MANCINI (NPI# 1285081695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285081695 |
| Entity Type | Individual |
| Full Name | CARLIE MANCINI |
| Credential | NP |
| Practice Address |
610 W Hays St Boise ID 83702-5511 |
| Mailing Address |
1720 N Westgate Dr Region Iv Mental Health Boise ID 83704-7164 |
| Practice Telephone | 2083815970 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | N-39732 | ID | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
54425 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1720 N Westgate Dr, Region Iv Mental Health, Boise, ID 837047164 | 2088615821 |
| Street Address |
610 W HAYS ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-5511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073759049 | Kimberly Reed Matias | Counselor | 610 W Hays St, Boise, ID 83702-5511 | 2008-12-22 |
| 1407480114 | Sabrina Sherwood | Pharmacist | 610 W Hays St, Boise, ID 83702-5511 | 2020-03-03 |
| 1659754810 | Shannon Leiambre Stamper | Dietitian, Registered | 610 W Hays St, Boise, ID 83702 | 2015-07-07 |
| 1558603134 | Rebecca E Headley | Social Worker | 610 W Hays St, Boise, ID 83702-5511 | 2013-03-21 |
| 1083977391 | Dawn L Powell | Nurse Practitioner | 610 W Hays St, Boise, ID 83702-5511 | 2012-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302594 | Dumu Psychiatry LLC | Nurse Practitioner | 9428 W Fairview Ave, Boise, ID 83704-8101 | 2020-06-29 |
| 1104309657 | Brigitta Panther | Nurse Practitioner | 418 W Reese St, Boise, ID 83706-6233 | 2018-09-11 |
| 1336413459 | Cheryl Suhr | Nurse Practitioner | 10840 W Wasdale Dr, Boise, ID 83709-7170 | 2012-03-07 |
| 1679898225 | Shawna L Kuehne | Nurse Practitioner | 1902 Judith Ln Ste 110, Boise, ID 83705-5235 | 2010-04-06 |
| 1841529310 | Carolyn Corbett | Nurse Practitioner | 7280 W Ustick Rd, Suite 101, Boise, ID 83704-5014 | 2009-12-13 |
| 1306089271 | Mark A Jepson | Nurse Practitioner | 1919 W State St, Boise, ID 83702-3958 | 2009-04-08 |
| 1548300924 | Gia Swope | Nurse Practitioner | 13967 W Wainwright Dr, Suite 103, Boise, ID 83713-2094 | 2007-02-07 |
| 1043392756 | Satu H. Woodland | Nurse Practitioner | 3152 S. Bown Way # 102, Boise, ID 83706 | 2006-10-20 |
| 1295735801 | Karen Lenore Schumacher | Nurse Practitioner | 2308 N Cole Rd, Ste A, Boise, ID 83704-7361 | 2005-07-26 |
| 1710593363 | Laura Lyn Allen | Nurse Practitioner | 3152 S Bown Way Ste 102, Boise, ID 83706-5456 | 2020-09-18 |
| 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.