| Functional Medicine Of North Idaho, Pllc | |
|
8382 N Wayne Dr Ste 204 Hayden ID 83835-6028 | |
| (208) 635-5265 | |
| (208) 635-5218 |
| Full Name | Functional Medicine Of North Idaho, Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 8382 N Wayne Dr Ste 204, Hayden, Idaho |
| Authorized Official Name and Position | Jessica Laplante (OWNER) |
| Authorized Official Contact | 2086355265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Functional Medicine Of North Idaho, Pllc 1399 N Biztown Loop Hayden ID 83835-5044 Ph: (208) 635-5265 | Functional Medicine Of North Idaho, Pllc 8382 N Wayne Dr Ste 204 Hayden ID 83835-6028 Ph: (208) 635-5265 |
| NPI Number | 1750920401 |
|---|---|
| Provider Enumeration Date | 12/29/2019 |
| Last Update Date | 07/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750920401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
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