Individual provider · Type 1 NPI

Stacy Marie Hackenmiller, FNP

Nurse Practitioner · Boise, ID

NPI number 1497623789 Active

Practice location

100 E Idaho St Ste 400
Boise, ID 83712-6267

Call (208) 381-4171 Map

Fax (208) 381-4172

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice locations

  • 9951 W St Lukes Dr, Nampa, ID 83687-7914 · (208) 467-6700

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X447128 (ID)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

5 other providers at this address

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About NPI 1497623789

Stacy Marie Hackenmiller, FNP's National Provider Identifier is 1497623789, issued on Oct 28, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Boise, ID. The record was last updated on Nov 17, 2025.