Healthcare Provider Details

I. General information

NPI: 1538701529
Provider Name (Legal Business Name): AUBREY BODILY RN, MSN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUBREY SALMOND CNP

II. Dates (important events)

Enumeration Date: 10/11/2019
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 W ORCHARD AVE
NAMPA ID
83651-1878
US

IV. Provider business mailing address

1007 W ORCHARD AVE
NAMPA ID
83651-1878
US

V. Phone/Fax

Practice location:
  • Phone: 208-461-2838
  • Fax: 208-461-5099
Mailing address:
  • Phone: 208-461-2838
  • Fax: 208-461-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP67339
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number8710894-3102
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number67339
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: