Provider Demographics
NPI:1194686667
Name:EMERGE WELLNESS
Entity type:Organization
Organization Name:EMERGE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYNDS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:208-960-4606
Mailing Address - Street 1:8849 GRIZZLY LN
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-1008
Mailing Address - Country:US
Mailing Address - Phone:208-417-3775
Mailing Address - Fax:
Practice Address - Street 1:8849 GRIZZLY LN
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-1008
Practice Address - Country:US
Practice Address - Phone:208-417-3775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-22
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center