Healthcare Provider Details

I. General information

NPI: 1588277529
Provider Name (Legal Business Name): TAUNA MARIE YOUNG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 S VISTA AVE STE 104
BOISE ID
83705-7343
US

IV. Provider business mailing address

2323 S VISTA AVE STE 104
BOISE ID
83705-7343
US

V. Phone/Fax

Practice location:
  • Phone: 208-992-4086
  • Fax: 208-210-1936
Mailing address:
  • Phone: 208-992-4086
  • Fax: 208-210-1936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number65111
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number65111
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: