Individual provider Active NPI

Kendra Ann Siguenza

  • Women's Health Nurse Practitioner
  • Nampa, ID
National Provider Identifier
1083595862
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
6171372 Issued in ID
Practice address
3908 E Flamingo Ave
Nampa, ID 83687-3102
Phone
(208) 442-8035
NPI assigned
Sep 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 6171372 ID Primary

Addresses

Primary practice location

3908 E Flamingo Ave
Nampa, ID 83687-3102

Mailing address

12670 S Conveyance Way
Nampa, ID 83686-6757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603002805 ID Practitioner - Nurse Practitioner 4688145378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3908 E Flamingo Ave
Nampa, ID 83687-3102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6171372IDMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestages OB-GYN PLLC CurrentSince Sep 14, 2025 Accepting new patients

Locations

3908 E Flamingo Ave
Nampa, ID 83687
Phone (208) 442-8035

1611 12th Ave Rd
Ste B
Nampa, ID 83686
Phone (208) 442-8035

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGJHBA/Endpoint/DGJHBA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1083595862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 S CONVEYANCE WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 E FLAMINGO AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873102",
            "telephone_number": "208-442-8035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGUENZA",
        "first_name": "KENDRA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ID",
            "license": "6171372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.