East Boise County Medical Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EAST BOISE COUNTY MEDICAL CLINIC

Practice address

3852 Highway 21
Boise, ID 83716

Phone

(208) 392-4544

Fax

(208) 392-4128

NPI assigned

Nov 19, 2011

Last updated

Nov 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lynda Joanne Maricle-Kuwahara, APRN-CNPI 1487633293

Title

Executive Director

Phone

(208) 392-4544

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lynda J Maricle-Kuwahara, APRN-C

  • Family Nurse Practitioner
  • Idaho City, ID
  • NPI 1487633293
  Authorized official Same address or phone

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

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321660800000",
    "number": "1255608238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3852 HIGHWAY 21",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83716",
            "telephone_number": "208-392-4544",
            "fax_number": "208-392-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3852 HIGHWAY 21",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83716",
            "telephone_number": "208-392-4544",
            "fax_number": "208-392-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BOISE COUNTY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-19",
        "last_updated": "2011-11-19",
        "status": "A",
        "authorized_official_last_name": "MARICLE-KUWAHARA",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-392-4544",
        "authorized_official_credential": "APRN-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.