Individual provider Active NPI

Stephanie Nielsen Baker, FNP

  • Family Nurse Practitioner
  • St Maries, ID
National Provider Identifier
1669990685
Registry record updated Aug 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
56789 Issued in ID
Practice address
229 S 7TH St
St Maries, ID 83861-1803
Phone
(208) 245-2591
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 56789 ID Primary

Addresses

Primary practice location

229 S 7TH St
St Maries, ID 83861-1803

Mailing address

229 S 7TH St
St Maries, ID 83861-1803

Other names 1

  • Stephanie Lee Nielsen Former name

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
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1669990685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803",
            "telephone_number": "208-245-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "STEPHANIE",
        "middle_name": "NIELSEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "56789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "NIELSEN",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Maries, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; 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.