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Organization
WESTERN SKIES WELLNESS AND PRIMARY CARE, PC
Active
Organization
WESTERN SKIES WELLNESS AND PRIMARY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI HANEY (CREDENTIALING/CONTRACTING)
(541) 410-5394
Entity
Organization
Contact information
Practice address
110 ILLINOIS AVE, COUNCIL, ID 83612
(208) 849-3725
(844) 689-3409
Mailing address
PO BOX 158, COUNCIL, ID 83612-0158
(208) 849-3725
(844) 689-3409
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
NULL
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
08/07/2026
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