DELORES MAYBACH (NPI# 1689191140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689191140 |
| Entity Type | Individual |
| Full Name | DELORES MAYBACH |
| Credential | NURSE PRACTITIONER |
| Practice Address |
4815 Cleveland Blvd Caldwell ID 83605-6501 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2084553545 |
| Practice Fax Number | 2084549690 |
| Mailing Telephone | 2089556500 |
| Mailing Fax Number | 2089556503 |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2019-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
56562 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | APRN LICENSE | 56562 | 01 |
| Street Address |
4815 CLEVELAND BLVD |
| City | CALDWELL |
| State | ID |
| Zip Code | 83605-6501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790713204 | Derek B Hamblin | Specialist | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2006-06-30 |
| 1710537964 | Donald E Sanford Jr. | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2019-09-18 |
| 1174038798 | Andrew Don Mcmurray | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2017-12-05 |
| 1174980346 | Ryan Wilson | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2016-01-19 |
| 1538565270 | Joshua Keith Wilding | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2014-11-07 |
| 1972905453 | Paddy Downey | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2014-09-16 |
| 1801089255 | Robert H Duff | Nurse Practitioner | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2007-08-20 |
| 1245321942 | Daryn J. Barnes | Physician Assistant | 4815 Cleveland Blvd, Caldwell, ID 83605-6501 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
| 1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
| 1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
| 1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
| 1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
| 1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
| 1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
| 1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
| 1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| Find all providers in zip 83605 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629622758 | Rachelle C. Friesen | Nurse Practitioner | 2123 Melody St, Caldwell, ID 83607-5190 | 2019-07-26 |
| 1801060892 | Clarice Rebecca Hall | Nurse Practitioner | 18125 Woodsfield Rd, Caldwell, OH 43724-9709 | 2008-04-22 |
| 1578680815 | Shirley Ann Levenson | Nurse Practitioner | 501 N Stone St, Caldwell, TX 77836-1134 | 2007-03-23 |
| 1609833250 | Lance Joseph Buxton | Nurse Practitioner | 2005 Arlington Ave, Caldwell, ID 83605-4808 | 2006-04-27 |
| 1962000653 | Jordyn Ashlie Oliver | Nurse Practitioner | 2609 S 10th Ave, Caldwell, ID 83605-6816 | 2020-10-14 |
| 1407461817 | Phoebe Ackart Uricchio | Nurse Practitioner | 2609 S 10th Ave, Caldwell, ID 83605-6816 | 2020-09-11 |
| 1609362318 | Juanita G Layne | Nurse Practitioner | 2005 Arlington Ave, Caldwell, ID 83605 | 2018-07-05 |
| 1376063321 | Molly Kay Partee | Nurse Practitioner | 415 S Osage St, Caldwell, KS 67022-1650 | 2017-06-21 |
| 1366991846 | Sharlynn Vantassell | Nurse Practitioner | 2609 S 10th Ave Ste 102, Caldwell, ID 83605-6885 | 2016-09-26 |
| 1902266174 | Lynn Lee | Nurse Practitioner | 304 Main St, Caldwell, OH 43724-1322 | 2016-03-02 |
| Find all providers in CALDWELL | ||||
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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.