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General NPI Number Information
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NPI Number | 1043794225
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Entity Type | Individual
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Provider Name | JACQUELINE MARIE SCHREMPP ND, NMD, LAC
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Gender | Female
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 600 E STATE ST STE 200
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City | EAGLE
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State | ID
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Zip | 83616-6082
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Country | US
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Telephone | 208-939-6748
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Fax |
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Provider Business Mailing Address
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Address Line | 790 S BLACK CAT RD
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City | KUNA
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State | ID
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Zip | 83634-1626
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Country | US
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Telephone | 775-846-4374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | ACU-362
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 4163
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NMD-0014
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License Number State | ID
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