Healthcare Provider Details

I. General information

NPI: 1780366195
Provider Name (Legal Business Name): SCIURIDAE BOYZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 N COLLEGE RD STE B
TWIN FALLS ID
83301-3386
US

IV. Provider business mailing address

738 N COLLEGE RD STE B
TWIN FALLS ID
83301-3386
US

V. Phone/Fax

Practice location:
  • Phone: 208-735-3600
  • Fax: 208-735-3601
Mailing address:
  • Phone: 208-735-3600
  • Fax: 208-735-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: AMBER LOUISE RAMSEY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 208-212-7196