Provider Demographics
NPI:1043794225
Name:SCHREMPP, JACQUELINE MARIE (ND, NMD, LAC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIE
Last Name:SCHREMPP
Suffix:
Gender:F
Credentials:ND, NMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 S BLACK CAT RD
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-1626
Mailing Address - Country:US
Mailing Address - Phone:775-846-4374
Mailing Address - Fax:
Practice Address - Street 1:600 E STATE ST STE 200
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6082
Practice Address - Country:US
Practice Address - Phone:208-939-6748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACU-362171100000X
OR4163175F00000X
IDNMD-0014175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist