# JENNIFER C MAIRE DNP PMHNP

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

## Provider details

- **NPI number:** 1790622819
- **Authorized official:** JENNIFER CHRISTINE MAIRE DNP, PMHNP-BC (OWNER, DNP, PMHNP)
- **Authorized official phone:** (208) 671-7013

## Contact information

- **Practice address:** 343 E 4TH N, REXBURG, ID 83440-6002
- **Practice address phone:** (208) 671-7013
- **Practice address fax:** (208) 932-4319
- **Mailing address:** 1999 S 25TH E STE 1016, AMMON, ID 83406-5710
- **Mailing address phone:** (208) 671-7013
- **Mailing address fax:** (208) 932-4319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2026
- **Last updated:** 04/29/2026