Healthcare Provider Details

I. General information

NPI: 1215363353
Provider Name (Legal Business Name): MAYA SCHIMPF NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 BELMONT ST
BOISE ID
83725-1351
US

IV. Provider business mailing address

1910 UNIVERSITY DR
BOISE ID
83725-1351
US

V. Phone/Fax

Practice location:
  • Phone: 208-426-1459
  • Fax:
Mailing address:
  • Phone: 208-426-1459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-1331A
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: