Organization
FUNCTIONAL MEDICINE OF NORTH IDAHO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LAPLANTE ARNP (OWNER)
(208) 635-5265
Entity
Organization
Contact information
Practice address
8382 N WAYNE DR STE 204, HAYDEN, ID 83835-6028
(208) 635-5265
(208) 635-5218
Mailing address
1399 N BIZTOWN LOOP, HAYDEN, ID 83835-5044
(208) 635-5265
(208) 635-5218
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/29/2019
Last updated
07/01/2024
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