Individual
JENNIFER RAE STALLINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2120 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2639
(208) 625-6944
(208) 625-6945
Mailing address
2120 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2639
(208) 625-6944
(208) 625-6945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
39413
ID
363LF0000X
Family Nurse Practitioner
67570
ID
Other
Enumeration date
06/22/2021
Last updated
09/16/2025
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