Provider Demographics
NPI:1043290414
Name:SCHIFFLER, BEVERLY A (FNP)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:A
Last Name:SCHIFFLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4074 S IRIONDO WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-5784
Mailing Address - Country:US
Mailing Address - Phone:208-426-9112
Mailing Address - Fax:
Practice Address - Street 1:112 S PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:NEW PLYMOUTH
Practice Address - State:ID
Practice Address - Zip Code:83655-5523
Practice Address - Country:US
Practice Address - Phone:208-278-3406
Practice Address - Fax:208-278-3418
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-619A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily