MEDICARE: EVERMAN FAMILY MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1316744998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERMAN FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	484 E LOCKHART LN
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-6580
Country	:	US
Telephone Number	:	208-830-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	4771 N SUMMIT WAY STE 110
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-5017
Country	:	US
Telephone Number	:	208-830-3156
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JESSICA MICHELLE EVERMAN
Credential	:	FNP
Telephone Number	:	208-830-3156

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	02/28/2025

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Directions to “EVERMAN FAMILY MEDICINE ” Practice Location

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