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Individual

JESSICA CAPAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
920 W IRONWOOD DR, SUITE 101, COEUR D ALENE, ID 83814-2463
(208) 667-4557
Mailing address
920 W IRONWOOD DR STE 101, COEUR D ALENE, ID 83814-2464

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-1572A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NP-1572A
ID STATE LICENSE
ID
Enumeration date
09/25/2015
Last updated
10/28/2025
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