Provider Demographics
NPI:1952895294
Name:HSNP PLLC
Entity Type:Organization
Organization Name:HSNP PLLC
Other - Org Name:HEATHER STOLWORTHY NP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NP, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STOLWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:208-287-0408
Mailing Address - Street 1:3135 E OVERLAND RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7369
Mailing Address - Country:US
Mailing Address - Phone:208-287-0408
Mailing Address - Fax:208-287-0423
Practice Address - Street 1:3135 E OVERLAND RD STE 110
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7369
Practice Address - Country:US
Practice Address - Phone:208-287-0408
Practice Address - Fax:208-287-0423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP610363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty