MEDICARE: JACQUELINE MARIE SCHREMPP ND, NMD, LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	ACU-362	ID
2	175F00000X	Naturopath	4163	OR
3	175F00000X	Naturopath	NMD-0014	ID

General Provider Information

NPI Number	:	1043794225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE MARIE SCHREMPP ND, NMD, LAC

Provider Business Mailing Address
First Line	:	790 S BLACK CAT RD
Second Line	:
City	:	KUNA
State	:	ID
Zip	:	83634-1626
Country	:	US
Telephone Number	:	775-846-4374
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 E STATE ST STE 200
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-6082
Country	:	US
Telephone Number	:	208-939-6748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	02/15/2021

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