Individual
JENNIFER MARIE BEAULIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9598
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
10007694
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
75717
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500819945
—
OR
Enumeration date
03/31/2023
Last updated
01/13/2026
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