Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 4163 | OR |
Y | 175F00000X | Naturopath | NMD-0014 | ID |
NPI | 1043794225 |
---|---|
Provider Name | Jacqueline Marie Schrempp |
First Address | Kuna, ID 83634-1626 |
Second Address | Eagle, ID 83616-6082 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 15/02/2021 |