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General NPI Number Information
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NPI Number | 1336762566
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Entity Type | Organization
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Legal Business Name | TREASURE VALLEY HEALTHCARE PLLC
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1120 S RACKHAM WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-1092
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Country | US
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Telephone | 208-577-8672
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Fax | 208-209-6058
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Provider Business Mailing Address
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Address Line | 5108 N MAIDSTONE WAY
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City | BOISE
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State | ID
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Zip | 83713-1367
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Country | US
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Telephone | 208-577-8672
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Fax | 208-939-6106
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Authorized Official
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Title or Position | CEO
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Name | CANDICE ELAINE ADAMS
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Credential | DNP
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Telephone | 208-577-8672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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