=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790931202
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE CLAPPERTON FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2008
-----------------------------------------------------
Last Update Date | 12/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1108 S WASHINGTON AVE
-----------------------------------------------------
City | EMMETT
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83617-3535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-365-3455
-----------------------------------------------------
Fax | 208-365-3422
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5998 LYNWOOD RD
-----------------------------------------------------
City | NAMPA
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83686-9510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-212-1985
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | NP-904A
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN002171
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 200850102NP
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------