Individual
AMBER JANE VAN SICKLE-BIRCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1500 PANCHERI DR STE 4, IDAHO FALLS, ID 83402-3212
(208) 579-6087
(888) 519-8898
Mailing address
1500 PANCHERI DR STE 4, IDAHO FALLS, ID 83402-3212
(208) 579-6087
(888) 519-8898
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
43554
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
70572
ID
Other
Enumeration date
06/28/2020
Last updated
09/06/2022
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