Healthcare Provider Details

I. General information

NPI: 1548172273
Provider Name (Legal Business Name): MELISSA GARCIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 S UNIVERSITY BLVD
NAMPA ID
83686-5800
US

IV. Provider business mailing address

17999 LONKEY LN
CALDWELL ID
83607-9641
US

V. Phone/Fax

Practice location:
  • Phone: 208-948-5004
  • Fax:
Mailing address:
  • Phone: 208-948-5004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number61355
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: