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Individual

MS. HEATHER A STOLWORTHY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
524 CLEVELAND BLVD., STE 110, CALDWELL, ID 83605
(573) 814-1170
(208) 287-0423
Mailing address
1574 S. LAKEMOOR WAY, EAGLE, ID 83616
(208) 716-8069
(208) 287-0423

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F0703081
ID
363L00000X
Nurse Practitioner
N23882
ID
363L00000X
Nurse Practitioner
NP610
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806691000
ID
Enumeration date
03/15/2006
Last updated
05/20/2024
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