Individual
WENDY M. SIEGERSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 468-5910
(208) 463-3044
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 463-3044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7236
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003921
BCBS
ID
01
—
000010149472
BLUE SHIELD
ID
01
—
080142087
RR MEDICARE
ID
01
—
72363
BCBS
ID
05
—
805092600
—
ID
01
—
806357000
HEALTHY CONNECTIONS
ID
01
—
PAUL1
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
11/25/2013
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