JACOB CRAIG STODDARD APRN-CNP NPI 1174464929

NPI Information

  • NPI: 1174464929
  • Provider Name: JACOB CRAIG STODDARD, APRN-CNP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 2455 BLUE CAMAS WAY
    IDAHO FALLS, ID
    ZIP 83402
  • Phone: (208) 242-8036

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NPI Details

Jacob Craig Stoddard, APRN-CNP is a primary care nurse practitioner in Idaho Falls, ID. Jacob Craig Stoddard, APRN-CNP NPI is 1174464929. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2455 BLUE CAMAS WAY
IDAHO FALLS, ID
ZIP 83402-849
Phone: (208) 242-8036

The enumeration date for this NPI number is 4/4/2026 and was last updated on 4/4/2026.

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
1363LP2300XNurse PractitionerPrimary Care5381502IDAHOYes

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: 11/21/2025

NPI Synchronization or Removal

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