Healthcare Provider Details

I. General information

NPI: 1619611415
Provider Name (Legal Business Name): ESTHER HENTER AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 6TH ST
LEWISTON ID
83501-2431
US

IV. Provider business mailing address

415 6TH ST
LEWISTON ID
83501-2434
US

V. Phone/Fax

Practice location:
  • Phone: 208-799-5540
  • Fax:
Mailing address:
  • Phone: 208-750-7462
  • Fax: 208-750-7467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number74463NP
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAP61371994
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: