Healthcare Provider Details

I. General information

NPI: 1467073379
Provider Name (Legal Business Name): MICHELLE MARIE TOMME NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 S MIDDLETON RD
NAMPA ID
83651
US

IV. Provider business mailing address

190 E BANNOCK ST
BOISE ID
83712-6241
US

V. Phone/Fax

Practice location:
  • Phone: 208-505-2800
  • Fax: 208-505-2801
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number72092
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95013835
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: