DR. LEONA JO'ANNE' CHURCH CPNP NPI 1073675617

NPI Information

NPI: 1073675617
Provider Name: DR. LEONA JO'ANNE' CHURCH, CPNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
1655 W FAIRVIEW AVE STE 206
BOISE, ID
ZIP 83702
Phone: (208) 395-0000
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DR. Leona Jo'anne' Church, CPNP is a pediatrics nurse practitioner in Boise, ID. DR. Leona Jo'anne' Church, CPNP NPI is 1073675617. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1655 W FAIRVIEW AVE STE 206
BOISE, ID
ZIP 83702-190
Phone: (208) 395-0000
Fax: (208) 395-0009

The enumeration date for this NPI number is 12/13/2006 and was last updated on 4/23/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	NP-157A	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1344916	MEDICARE ID-TYPE UNSPECIFIED	IDAHO
2	S99759	MEDICARE UPIN	IDAHO
3	805703400	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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