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General NPI Number Information
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NPI Number | 1396245742
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Entity Type | Individual
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Provider Name | BILLIESUE MAYO AGNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 1901 CALDWELL BLVD
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City | NAMPA
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State | ID
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Zip | 83651-1506
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Country | US
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Telephone | 208-318-1619
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Fax | 888-280-0255
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Provider Business Mailing Address
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Address Line | 1901 CALDWELL BLVD
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City | NAMPA
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State | ID
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Zip | 83651-1506
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Country | US
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Telephone | 208-318-1619
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Fax | 888-280-0255
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 57993
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 57993
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 57993
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 57993
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 57993
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License Number State | ID
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