Individual
STEPHANIE M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3525 E LOUISE DR STE 401, MERIDIAN, ID 83642-6303
(208) 322-1680
(208) 322-1695
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4071397
ID
363L00000X
Nurse Practitioner
AP61515215
WA
363LA2100X
Acute Care Nurse Practitioner
1682.1682
WY
Other
Enumeration date
09/13/2016
Last updated
01/19/2026
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