Healthcare Provider Details

I. General information

NPI: 1285474593
Provider Name (Legal Business Name): JOFEL FRANCIS OCONER DEL MUNDO FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 05/27/2024
Certification Date: 05/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 CALDWELL BLVD
NAMPA ID
83651-1505
US

IV. Provider business mailing address

15710 EMERALD PINE CT
CALDWELL ID
83607-8441
US

V. Phone/Fax

Practice location:
  • Phone: 208-466-6567
  • Fax: 208-466-6567
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: