NPI Code Detail JSON Logo

1336762566 NPI number — TREASURE VALLEY HEALTHCARE PLLC

NPI Number: 1336762566
Health Care Provider/Practitioner: TREASURE VALLEY HEALTHCARE PLLC

Information about “1336762566” NPI (TREASURE VALLEY HEALTHCARE PLLC) exists in 1336762566 in HTML format HTML  |  1336762566 in plain Text format TXT  |  1336762566 in PDF (Portable Document Format) PDF  |  1336762566 in an XML format XML  formats.

NPI Number : 1336762566 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336762566",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TREASURE VALLEY HEALTHCARE PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5108 N MAIDSTONE WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOISE",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83713-1367",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-577-8672",
    "MailingAddressFaxNumber": "208-939-6106",
    "FirstLinePracticeLocationAddress": "1120 S RACKHAM WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MERIDIAN",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83642-1092",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-577-8672",
    "PracticeLocationAddressFaxNumber": "208-209-6058",
    "EnumerationDate": "05/21/2020",
    "LastUpdateDate": "07/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ADAMS",
    "AuthorizedOfficialFirstName": "CANDICE",
    "AuthorizedOfficialMiddleName": "ELAINE",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DNP",
    "AuthorizedOfficialTelephoneNumber": "208-577-8672",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.