Healthcare Provider Details

I. General information

NPI: 1609700848
Provider Name (Legal Business Name): MRS. STEPHANIE FRANCINE MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FORT ST
BOISE ID
83702-4501
US

IV. Provider business mailing address

4511 N TEMPEST WAY
MERIDIAN ID
83646-3767
US

V. Phone/Fax

Practice location:
  • Phone: 208-422-1356
  • Fax:
Mailing address:
  • Phone: 208-391-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: