=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588532329
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DESIGNERS MEDICINE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2025
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4605 ENTERPRISE WAY STE 105
-----------------------------------------------------
City | CALDWELL
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83605-6889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-239-7486
-----------------------------------------------------
Fax | 866-247-0438
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4605 ENTERPRISE WAY STE 105
-----------------------------------------------------
City | CALDWELL
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83605-6889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-239-7486
-----------------------------------------------------
Fax | 866-247-0438
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | WILLIAM STEERS
-----------------------------------------------------
Credential | FNP
-----------------------------------------------------
Telephone | 208-230-7486
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------