Active NPI
Lynda J Maricle-Kuwahara, APRN-C
- Family Nurse Practitioner
- Idaho City, ID
National Provider Identifier
1487633293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP289
- Practice address
- 3852 Highway 21
Idaho City, ID 83631-4176 - Phone
- (208) 392-4544
- Fax
- (208) 392-4128
- NPI assigned
- Jan 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP289 | ID | Primary |
Addresses
Primary practice location
3852 Highway 21
Idaho City, ID 83631-4176
Mailing address
3852 Highway 21
P.O. Box 554
Idaho City, ID 83631-4176
Phone (208) 392-4544
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP497 | Other | ID | BLUE CROSS |
Other names 1
- Lynda J Maricle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP289 | ID | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197936000000",
"number": "1487633293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3852 HIGHWAY 21",
"address_2": "P.O. BOX 554",
"city": "IDAHO CITY",
"state": "ID",
"postal_code": "836314176",
"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": "IDAHO CITY",
"state": "ID",
"postal_code": "836314176",
"telephone_number": "208-392-4544",
"fax_number": "208-392-4128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARICLE-KUWAHARA",
"first_name": "LYNDA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "APRN-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2007-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "NP289",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "NP497",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LYNDA",
"last_name": "MARICLE",
"middle_name": "J",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Idaho City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.