Individual
MS. REBEKAH G FAYETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, PMHNP
Contact information
Practice address
4477 W EMERALD ST STE C200, BOISE, ID 83706-2074
(208) 780-9295
(855) 490-9559
Mailing address
10280 W USTICK RD, BOISE, ID 83704-5270
(208) 780-9295
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
54388
ID
367A00000X
Advanced Practice Midwife
54388
ID
Other
Enumeration date
06/03/2015
Last updated
08/11/2025
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