Idaho NP Clinic PLLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

IDAHO NP CLINIC PLLC

Practice address

1883 Wildwood St Ste C
Boise, ID 83713-5146

Phone

(662) 571-7651

NPI assigned

Mar 2, 2021

Last updated

May 21, 2021By 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

Mrs. Jennifer Hofer, NPNPI 1215396478

Title

Owner

Phone

(208) 901-7006

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.

• Jennifer Ann Fulton Hofer, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Boise, ID
  • NPI 1215396478
  NPD Authorized official

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1790370765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 WILDWOOD ST STE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135146",
            "telephone_number": "208-901-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 WILDWOOD ST STE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135146",
            "telephone_number": "662-571-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO NP CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-05-21",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "HOFER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-901-7006",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho Nephrology Associates, L.L.C
• Idaho Neurological Surgery, P.a.
• Idaho Neurology PLLC
• Idaho Neuropsychology, PLLC
• Idaho Novus Classical Academy
• Idaho Nutrition and Wellness Clinic
• Idaho Ortho Spine, PLLC
• Idaho Pain Center
• Idaho Pain Medicine, LLP
• Idaho Pediatric Gastroenterology PA

• Primary Care Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.