IDAHO STATE UNIVERSITY NPI 1366033094

NPI Information

NPI: 1366033094
Provider Name: IDAHO STATE UNIVERSITY

Other Name: ISU INTEGRATED MENTAL HEALTH

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
1311 E CENTRAL DR
MERIDIAN, ID
ZIP 83642
Phone: (208) 373-1979
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IDAHO STATE UNIVERSITY is a psychiatric/mental health nurse practitioner in Meridian, ID. IDAHO STATE UNIVERSITY NPI is 1366033094. The provider is registered as an organization entity type.
The provider Other Name Is Isu Integrated Mental Health.

The provider's business location address is:

1311 E CENTRAL DR
MERIDIAN, ID
ZIP 83642-991
Phone: (208) 373-1979
Fax: (833) 499-1813

The provider's authorized official is Cynthia Lee Rock .
The authorized official title is Clinics Director Of Operations and has the following contact phone number (208) 373-1743.

The enumeration date for this NPI number is 1/26/2021 and was last updated on 8/27/2021.

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	3336S0011X	Pharmacy	Specialty Pharmacy			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

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

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