Healthcare Provider Details

I. General information

NPI: 1255207668
Provider Name (Legal Business Name): KIMBERLY LYNN HUTCHINSON B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 10TH AVE S
NAMPA ID
83651-3832
US

IV. Provider business mailing address

3201 COLLEGE AVE
CALDWELL ID
83605-6133
US

V. Phone/Fax

Practice location:
  • Phone: 208-614-2998
  • Fax: 208-468-0851
Mailing address:
  • Phone: 208-602-6292
  • Fax: 208-468-0851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: