# ROCKY MOUNTAIN WELLNESS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326915000
- **Authorized official:** KYLEE DEE JOHNSON APRN, CNM, WHNP (OWNER/PROVIDER)
- **Authorized official phone:** (208) 973-1162

## Contact information

- **Practice address:** 2065 E 17TH ST STE A, IDAHO FALLS, ID 83404-8042
- **Practice address phone:** (208) 497-0541
- **Practice address fax:** (208) 497-0873
- **Mailing address:** 2065 E 17TH ST STE A, IDAHO FALLS, ID 83404-8042
- **Mailing address phone:** (208) 497-0541
- **Mailing address fax:** (208) 497-0873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/20/2025
- **Last updated:** 10/20/2025