Organization
WESTERN SKIES WELLNESS AND PRIMARY CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI HANEY (CREDENTIALING/CONTRACTING)
(541) 410-5394
Entity
Organization
Contact information
Practice address
119 ILLINOIS AVE, COUNCIL, ID 83612-7709
(208) 849-3725
Mailing address
PO BOX 158, COUNCIL, ID 83612-0158
(208) 849-3725
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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