Provider Demographics
NPI:1205207313
Name:LEMA, ALISHA LAUREN (NP)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:LAUREN
Last Name:LEMA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:LAUREN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-381-8752
Mailing Address - Fax:
Practice Address - Street 1:450 W STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7055
Practice Address - Country:US
Practice Address - Phone:208-939-1035
Practice Address - Fax:208-939-8970
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1633A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily