Dermatology
EAGLE DERMATOLOGY, PLLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1417456385 · enumerated 2018-02-06 · record updated 2018-02-06. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Mrs. JENNIFER GUERRERO, Practice Manager · (208) 391-7210
Addresses and phones
- Mailing address 372 S EAGLE RD # 126, EAGLE, ID, 83616-5908 (208) 391-7210 Fax (208) 391-2130 Google Maps Apple Maps OpenStreetMap
- Practice location 323 E RIVERSIDE DR STE 234, EAGLE, ID, 83616-6865 (208) 391-7210 Fax (208) 391-2130 Google Maps Apple Maps OpenStreetMap
Specialties
- Dermatology, MOHS-Micrographic Surgery 207ND0101X · License O-1094 ID
- Dermatology, Dermatopathology 207ND0900X · License O-1094 ID
- Dermatology, Clinical & Laboratory Dermatological Immunology 207NI0002X · License O-1094 ID
- Dermatology, Pediatric Dermatology 207NP0225X · License O-1094 ID
- Dermatology, Procedural Dermatology 207NS0135X · License O-1094 ID
- Dermatology 207N00000X · Primary · License O-1094 ID
In this directory
Locations and evidence
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Practice location
EAGLE, ID, 836166865
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.