Healthcare Provider Details

I. General information

NPI: 1568151157
Provider Name (Legal Business Name): KATY FOUTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5826 E FRANKLIN RD
NAMPA ID
83687-5020
US

IV. Provider business mailing address

9223 S FORAKER AVE
KUNA ID
83634-5328
US

V. Phone/Fax

Practice location:
  • Phone: 208-593-6340
  • Fax: 208-593-6341
Mailing address:
  • Phone: 208-724-6903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number2871578
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number6671274
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number31881
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: