DARA ANDERSON (NPI# 1558921429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558921429 |
| Entity Type | Individual |
| Full Name | DARA ANDERSON |
| Credential | NP-C |
| Practice Address |
4750 N Five Mile Rd Boise ID 83713-2715 |
| Practice Telephone | 2089960931 |
| Mailing Telephone | 2089960931 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-01-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
11450495-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
61268 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4460 S Highland Dr Ste 210, Salt Lake City, UT 841243550 | 8889494864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043876303 | Dara Elizabeth Anderson | Counselor | 5410 N 44th St, Tacoma, WA 98407-3715 | 2019-05-13 |
| Street Address |
4750 N FIVE MILE RD |
| City | BOISE |
| State | ID |
| Zip Code | 83713-2715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205819950 | Kirk A. Campana | General Practice | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2005-11-28 |
| 1346868163 | Krystan Welborn | Community Health Worker | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2020-07-08 |
| 1831473198 | Cali Bradberry | Physician Assistant | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2011-10-05 |
| 1073601233 | Physicians Clinic Pllc | Family Medicine | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2006-10-11 |
| 1487760740 | Terry M Little | Family Medicine | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2006-08-21 |
| 1275545568 | Cheryl C Amyx | Nurse Practitioner | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2006-08-13 |
| 1326003377 | Mary Paige Jeffress | Nurse Practitioner | 4750 N Five Mile Rd, Boise, ID 83713-2715 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568061398 | Nicolette A Eberline | Nurse Practitioner | 4228 W Guard St Bldg 665, Boise, ID 83705-8049 | 2020-10-22 |
| 1013522275 | Beau Lee | Nurse Practitioner | 2900 N Burton St, Boise, ID 83704-5314 | 2020-09-14 |
| 1588277529 | Tauna Marie Young | Nurse Practitioner | 1681 S Kimball Way, Boise, ID 83709-1654 | 2020-08-28 |
| 1497367114 | Lindsay Ruggles | Nurse Practitioner | 1105 S Federal Way, Boise, ID 83705-2546 | 2020-08-24 |
| 1265056014 | Brynn Crisp | Nurse Practitioner | 1075 N Curtis Rd Ste 100, Boise, ID 83706-1348 | 2020-06-07 |
| 1518592674 | Amber Lynn Gillette | Nurse Practitioner | 1111 S Orchard St Ste 251, Boise, ID 83705-1964 | 2020-03-10 |
| 1265062806 | Jamie Watts | Nurse Practitioner | 5353 W Hill Rd, Boise, ID 83703-2943 | 2020-01-23 |
| 1730654435 | Melissa Gaffrey | Nurse Practitioner | 500 S 8th St, Boise, ID 83702-7107 | 2018-10-09 |
| 1659876399 | Dixie Jean Skinner | Nurse Practitioner | 10583 W. Lake Hazel Rd., Boise, ID 83709-8370 | 2018-03-26 |
| 1063912202 | Devon Moser | Nurse Practitioner | 901 N Curtis Rd Ste 100, Boise, ID 83706-1339 | 2018-02-14 |
| 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.