=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992934103
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARI PAYNTER SPAETE AUD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2009
-----------------------------------------------------
Last Update Date | 11/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 172 2ND ST S
-----------------------------------------------------
City | NAMPA
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83651-3708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-489-5950
-----------------------------------------------------
Fax | 208-461-5623
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1100
-----------------------------------------------------
City | BOISE
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83701-1100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-737-2126
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | AUD-1872
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------