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NPI Code Detail

MEDICARE: KRISTYN A SCHELHAAS D.O.

MEDICARE: KRISTYN A SCHELHAAS D.O.
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
1207Q00000XFamily Medicine PhysicianR7928IA
2207Q00000XFamily Medicine Physician0-0528ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366453524
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTYN A SCHELHAAS D.O.
Provider Business Mailing Address
First Line : PO BOX 191050
Second Line :
City : BOISE
State : ID
Zip : 83719-1050
Country : US
Telephone Number : 208-955-6500
Fax Number : 208-955-6501
Provider Business Practice Location Address
First Line : 1375 N HAPPY VALLEY RD
Second Line :
City : NAMPA
State : ID
Zip : 83687-5280
Country : US
Telephone Number : 208-809-2869
Fax Number : 208-809-2861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 11/15/2022

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