Healthcare Provider Details

I. General information

NPI: 1316098403
Provider Name (Legal Business Name): DORIS E ZIEGELDORF ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 17TH ST
LEWISTON ID
83501-3652
US

IV. Provider business mailing address

1522 17TH ST
LEWISTON ID
83501-3652
US

V. Phone/Fax

Practice location:
  • Phone: 208-743-8416
  • Fax: 208-743-4642
Mailing address:
  • Phone: 208-743-8416
  • Fax: 208-743-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP361A
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: