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Organization
FUNCTIONAL MEDICINE OF NORTH IDAHO, PLLC
Active
Organization
FUNCTIONAL MEDICINE OF NORTH IDAHO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LAPLANTE ARNP (OWNER)
(208) 635-5265
Entity
Organization
Contact information
Practice address
8382 N WAYNE DR STE 204, HAYDEN, ID 83835-6028
(208) 635-5265
(208) 635-5218
Mailing address
1399 N BIZTOWN LOOP, HAYDEN, ID 83835-5044
(208) 635-5265
(208) 635-5218
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/29/2019
Last updated
07/01/2024
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