Healthcare Provider Details

I. General information

NPI: 1376167114
Provider Name (Legal Business Name): AMY MICHELE ZAPPIA DNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2020
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 E GENTRY WAY STE 210
MERIDIAN ID
83642-3013
US

IV. Provider business mailing address

1763 W GLADE CREEK ST
MERIDIAN ID
83646-4304
US

V. Phone/Fax

Practice location:
  • Phone: 208-384-9022
  • Fax:
Mailing address:
  • Phone: 208-914-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberN-40995
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number65133
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: