Healthcare Provider Details

I. General information

NPI: 1831827310
Provider Name (Legal Business Name): EROS HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 07/23/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST STE 1460
BOISE ID
83702-5983
US

IV. Provider business mailing address

1301 S MILLSTREAM DR
NAMPA ID
83686-4837
US

V. Phone/Fax

Practice location:
  • Phone: 208-352-2290
  • Fax: 833-471-6098
Mailing address:
  • Phone: 208-559-6494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER JEAN MIMISH
Title or Position: OWNER, NURSE PRACTITIONER
Credential: CNM, WHNP
Phone: 208-559-6494