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General NPI Number Information
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NPI Number | 1972303089
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Entity Type | Organization
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Legal Business Name | SUPERIOR MEDICAL SERVICE, PLLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 10323 COLORFUL DR
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City | NAMPA
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State | ID
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Zip | 83687-5163
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Country | US
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Telephone | 208-936-1418
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Fax |
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Provider Business Mailing Address
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Address Line | 10323 COLORFUL DR
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City | NAMPA
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State | ID
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Zip | 83687-5163
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Country | US
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Telephone | 208-936-1418
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Fax |
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Authorized Official
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Title or Position | OWNER/ NURSE PRACTITIONER
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Name | MICHELLE RENEE RICK
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Credential | AGNP-C
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Telephone | 208-936-1418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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