Healthcare Provider Details

I. General information

NPI: 1427806637
Provider Name (Legal Business Name): STEPHANIE YOUREN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2024
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16700 N MARKETPLACE BLVD
NAMPA ID
83687-7909
US

IV. Provider business mailing address

16700 N MARKETPLACE BLVD
NAMPA ID
83687-7909
US

V. Phone/Fax

Practice location:
  • Phone: 208-465-3813
  • Fax: 208-465-3814
Mailing address:
  • Phone: 208-465-3813
  • Fax: 208-465-3814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberATI4719
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: