Provider Demographics
NPI:1831510817
Name:NORTHAM-MOBLEY, EMILY (RN, APRN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:NORTHAM-MOBLEY
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 18TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-4841
Mailing Address - Country:US
Mailing Address - Phone:208-283-7314
Mailing Address - Fax:
Practice Address - Street 1:116 18TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-4841
Practice Address - Country:US
Practice Address - Phone:208-283-7314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID4771367363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health