P Praxis·MD
● Active Type 1 · Individual

Stacy A Fitzgerald, CST

Specialist/Technologist, Other·Boise, ID· NPI 1730247719 · Enumerated 2006 · 19 years on NPI
Fitzgerald is 1 of 20 specialist/technologist, other providers in Boise and 1 of 39 in Idaho.
NPI age
19 years
Enumerated 2006-12-04
Primary specialty
Specialist/Technologist, Other
Licensed in
0 states
Status
Active
No deactivations on record
Last NPPES update
2011-07-20
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 39 active specialist/technologist, other providers in Idaho.

NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
5% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-12Enumerated in NPPES
2006 2026

Where they practice

Practice location
4887 Wymosa St
Boise, ID 837034359
📞 2088907984
Mailing address
190 E Bannock St
Boise, ID 83712
📞 2088907984

Specialties

  • Specialist/Technologist, Other Primary
    Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the...
    taxonomy 246ZS0410X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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