Individual
MELISSA WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1210 NW 16TH ST, FRUITLAND, ID 83619-2202
(208) 452-8700
(208) 452-8701
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
53844
ID
363L00000X
Nurse Practitioner
Primary
53844
ID
Other
Enumeration date
05/01/2025
Last updated
08/21/2025
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