Organization Active NPI

North Haven Aesthetics & Wellness PLLC

  • Family Nurse Practitioner
  • Eagle, ID
National Provider Identifier
1063343705
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NORTH HAVEN AESTHETICS & WELLNESS PLLC
Practice address
219 S Wooddale Ave
Eagle, ID 83616-7714
Phone
(208) 994-5575
NPI assigned
May 28, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelsey Sieger, FNP-CNPI 1699617266
Title
Owner
Phone
(208) 994-5575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

219 S Wooddale Ave
Eagle, ID 83616-7714

Mailing address

10400 W Overland Rd
Boise, ID 83709-1433

National Provider Directory

National Provider Directory

Locations

219 S Wooddale Ave
Eagle, ID 83616
Phone (208) 994-5575

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1063343705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S WOODDALE AVE",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167714",
            "telephone_number": "208-994-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH HAVEN AESTHETICS & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "SIEGER",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-994-5575",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.