MITZI M CIESLAK (NPI# 1326388653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326388653 |
| Entity Type | Individual |
| Full Name | MITZI M CIESLAK |
| Credential | NP |
| Practice Address |
100 E Idaho St Ste 200 Boise ID 83712-6267 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083817360 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2013-02-23 |
| Last Update Date | 2013-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
N25439 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 E IDAHO ST STE 200 |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133776 | Gregory G Janos | Pediatrics | 100 E Idaho St, Suite 200, Boise, ID 83712-6267 | 2005-08-31 |
| 1205444734 | Allison Reed | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-21 |
| 1619585247 | Christina Gullion | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-20 |
| 1548897556 | Brooke Hueftle | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-03-27 |
| 1194364919 | Sarah Rosemarie Hogue | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-26 |
| 1710525167 | Leslie Lynn Lamontagne | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1487292843 | Lauren Zupsic | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1659919199 | Stephanie Matta | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1104464627 | David Blair Wilson | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1386282788 | Jessie Modlin | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959100 | Taylor Frances Mello | Nurse Practitioner | 2770 N Woodview Pl, Boise, ID 83702-6541 | 2020-07-17 |
| 1275192205 | Luna Hodges | Nurse Practitioner | 125 E Idaho St Ste 200, Boise, ID 83712-6225 | 2019-06-12 |
| 1073675617 | Leona Jo'anne' Church | Nurse Practitioner | 1655 W Fairview Ave Ste 206, Boise, ID 83702-5190 | 2006-12-13 |
| 1386204758 | Aimee Lynn Hastriter | Nurse Practitioner | 125 E Idaho St Ste 200, Boise, ID 83712-6225 | 2019-06-18 |
| 1659844066 | Rachel Bentley | Nurse Practitioner | 1072 N Liberty St Ste 200, Boise, ID 83704-8963 | 2019-01-08 |
| 1760845259 | Jill Moughamian | Nurse Practitioner | 4700 N Cloverdale Rd Ste 103, Boise, ID 83713-1067 | 2016-04-01 |
| 1083977391 | Dawn L Powell | Nurse Practitioner | 610 W Hays St, Boise, ID 83702-5511 | 2012-06-21 |
| 1437467644 | Jaeger A Ashton | Nurse Practitioner | 305 E Jefferson St, Boise, ID 83712-6273 | 2010-09-22 |
| 1619158144 | Margaret A Henbest | Nurse Practitioner | 190 E Bannock St, Boise, ID 83712-6241 | 2007-11-27 |
| 1811184492 | Alisa D. Ortega | Nurse Practitioner | 417 S 6th St, Boise, ID 83702-7632 | 2007-09-27 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.