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FUNCTIONAL MEDICINE OF NORTH IDAHO, PLLC

Organization (NPI-2) Active

Nurse Practitioner

Provider Information

NPI Number
1750920401
Provider Type
Organization / Facility (NPI-2)
Status
Active

Contact & Location

Address
8382 N WAYNE DR STE 204, HAYDEN, ID, 838356028
Phone
(208) 635-5265
Fax
(208) 635-5218

Specialties & Taxonomies

Clinic/Center
Nurse Practitioner Primary

All Addresses

LOCATION

8382 N WAYNE DR STE 204

HAYDEN, ID, 838356028

(208) 635-5265

MAILING

1399 N BIZTOWN LOOP

HAYDEN, ID, 838355044

(208) 635-5265