Healthcare Provider Details

I. General information

NPI: 1386430494
Provider Name (Legal Business Name): AKINS CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 SHOUP AVE W
TWIN FALLS ID
83301-5028
US

IV. Provider business mailing address

419 SHOUP AVE W
TWIN FALLS ID
83301-5028
US

V. Phone/Fax

Practice location:
  • Phone: 208-991-9323
  • Fax: 208-944-2566
Mailing address:
  • Phone: 208-991-9323
  • Fax: 208-944-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CATRINA M GURULE
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 208-991-9323