Active NPI
Amanda Duplisea, FNP
- Family Nurse Practitioner
- Boise, ID
National Provider Identifier
1730962150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 77027
- Practice address
- 500 W Fort St
Boise, ID 83702-4501 - Phone
- (801) 662-8540
- NPI assigned
- Aug 17, 2023
- Last updated
- Sep 7, 2024
- 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 | 77027 | ID | Primary |
Addresses
Primary practice location
500 W Fort St
Boise, ID 83702-4501
Mailing address
6029 N Hampstead Ave
Boise, ID 83714-2032
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77027 | ID | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725667200000",
"number": "1730962150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6029 N HAMPSTEAD AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837142032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W FORT ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024501",
"telephone_number": "801-662-8540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPLISEA",
"first_name": "AMANDA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-17",
"last_updated": "2024-09-07",
"certification_date": "2024-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "77027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.