Provider Demographics
NPI:1760584346
Name:HILPERT, STEPHANIE M (NP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:HILPERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 CURTISIAN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8880
Mailing Address - Country:US
Mailing Address - Phone:208-367-3500
Mailing Address - Fax:208-367-2968
Practice Address - Street 1:6140 CURTISIAN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8880
Practice Address - Country:US
Practice Address - Phone:208-367-3500
Practice Address - Fax:208-367-2968
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP753A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0214563OtherWA DEPARTMENT OF LABOR
ID807623700Medicaid
IDNPXZ4OtherBLUE CROSS OF ID
ID000010157664OtherBLUE SHIELD OF ID
ID807623700Medicaid
WA0214563OtherWA DEPARTMENT OF LABOR
IDQ76483Medicare UPIN