Provider Demographics
NPI:1770631129
Name:RITCHIE, HEIDI VIRLEE (NP-C)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:VIRLEE
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:VIRLEE
Other - Last Name:RITCHIE-LOSSMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:420 W MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702
Mailing Address - Country:US
Mailing Address - Phone:208-429-1627
Mailing Address - Fax:208-344-2104
Practice Address - Street 1:420 W MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702
Practice Address - Country:US
Practice Address - Phone:208-429-1627
Practice Address - Fax:208-344-2104
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP598A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health