Organization
SENSITIVE MENTAL HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE S WILSON NP (PRESIDENT)
(208) 818-1411
Entity
Organization
Contact information
Practice address
7905 N MEADOWLARK WAY, SUITE B, COEUR D ALENE, ID 83815-5041
(208) 818-1411
(208) 772-7677
Mailing address
419 N BRUSHWOOD CT, POST FALLS, ID 83854-6764
(208) 818-1411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-999A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036263
REGENCE
—
01
—
12224429
CAQH
—
05
—
1790081032
—
ID
01
—
8P321
BLUE CROSS
—
Enumeration date
02/03/2011
Last updated
07/05/2013
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