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Eagle Dermatology, Pllc

Dermatology Physician in Eagle, ID · enumerated 2018 · authorized official Jennifer Guerrero, Practice Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1417456385

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Registry record

Entity type Organization (Type 2)
Legal business name Eagle Dermatology, Pllc
Practice address 323 E Riverside Dr Ste 234, Eagle, ID, 83616
Phone (208) 391-7210
Fax (208) 391-2130
Enumeration date Feb 6, 2018
Last updated in NPPES Feb 6, 2018

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians · License O-1094 (ID) Primary
207ND0101X MOHS-Micrographic Surgery Physician Allopathic & Osteopathic Physicians · License O-1094 (ID) Secondary
207ND0900X Dermatopathology Physician Allopathic & Osteopathic Physicians · License O-1094 (ID) Secondary
207NI0002X Clinical & Laboratory Dermatological Immunology Physician Allopathic & Osteopathic Physicians · License O-1094 (ID) Secondary
207NP0225X Pediatric Dermatology Physician Allopathic & Osteopathic Physicians · License O-1094 (ID) Secondary
207NS0135X Procedural Dermatology Physician Allopathic & Osteopathic Physicians · License O-1094 (ID) Secondary

Authorized official

Name Jennifer Guerrero
Title Practice Manager
Phone (208) 391-7210

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Eagle Dermatology, Pllc?
Eagle Dermatology, Pllc is registered in NPPES as a Dermatology Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-02-06.