Judy A Kienzle, N.P.-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP450A Issued in ID

Practice address

1515 W State St
Boise, ID 83702-4039

Phone

(208) 345-6768

NPI assigned

Jun 15, 2006

Last updated

Apr 10, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239321600000",
    "number": "1740224328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E. GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024039",
            "telephone_number": "208-345-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENZLE",
        "first_name": "JUDY",
        "middle_name": "A",
        "credential": "N.P.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-094411",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP450A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidscare Home Health of Idaho, LLC
• Mark E Kieckbusch, M.D.
• Margarete Marjorie Kiefer-Ebben
• John Joseph Kiehl, MD
• Jennifer Kienlen, MS, AG-ACNP
• Kathryn Rose Kiernan, OTR
• Julie S Kikuchi, M.D.
• Kenon Kildew, N.P.
• Michael Joseph Kilfoyle, MD
• Ian Killen

• 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 Apr 10, 2009; 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.