Healthcare Provider Details

I. General information

NPI: 1871073528
Provider Name (Legal Business Name): VALERIE JOANN ROUNDS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8512 N WAYNE DR
HAYDEN ID
83835-5218
US

IV. Provider business mailing address

8512 N WAYNE DR STE B
HAYDEN ID
83835-5218
US

V. Phone/Fax

Practice location:
  • Phone: 208-361-2146
  • Fax: 208-415-4805
Mailing address:
  • Phone: 208-213-2433
  • Fax: 208-415-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number47121
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberID59455
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: