Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Maverick Mitton, FNP-C

Individual provider Family Nurse Practitioner · NPI 1396602249

Maverick Mitton, FNP-C is a Nurse Practitioner in Twin Falls, Idaho. Qualified in 2025, 1 year ago. Practices with St Lukes Clinic LLC, a 310-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
1
Licensed in
ID
In the registry since
2026
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

775 Pole Line Rd W Ste 103
Twin Falls, ID 83301-5819
Phone: (208) 814-8375
Fax: (208) 814-8376
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 5671698 (ID)

Record details

NPI number1396602249
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2026
Last updated in NPPESMarch 9, 2026
Certification dateMarch 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice St Lukes Clinic Llc — 310 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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