Individual
JILL MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3700 W SELTICE WAY, COEUR D ALENE, ID 83814-8921
(208) 620-5255
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N-29302
ID
163WP0808X
Psychiatric/Mental Health Registered Nurse
806071
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
23667
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP60533440
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-1397A
ID
Other
Enumeration date
03/15/2010
Last updated
03/04/2025
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