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Individual

JENNIFER REBECCA WILDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24244 E DESMET RD, LIBERTY LAKE, WA 99019-7609
(208) 420-7078
Mailing address
24244 E DESMET RD, LIBERTY LAKE, WA 99019-7609
(208) 420-7078

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
60076186
WA

Other

Enumeration date
11/24/2025
Last updated
11/24/2025
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