Healthcare Provider Details

I. General information

NPI: 1801488044
Provider Name (Legal Business Name): STEVEN DANIEL ESPLIN PMHNP-DNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 E 17TH ST
AMMON ID
83406-6601
US

IV. Provider business mailing address

1584 S SAGE VIEW CT
SARATOGA SPRINGS UT
84045-6453
US

V. Phone/Fax

Practice location:
  • Phone: 208-346-7500
  • Fax:
Mailing address:
  • Phone: 801-472-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number66774
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: