Provider Demographics
NPI:1639331069
Name:NAUGLE, EMILY JEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:JEAN
Last Name:NAUGLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 12TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-4658
Mailing Address - Country:US
Mailing Address - Phone:208-466-9251
Mailing Address - Fax:208-463-1714
Practice Address - Street 1:1205 S FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-1304
Practice Address - Country:US
Practice Address - Phone:208-322-8381
Practice Address - Fax:208-322-8381
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP-100161152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist