Organization
YELLOW DAISY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA BLONQUIST BCNP-PMHNP (MANAGER)
(208) 715-6709
Entity
Organization
Contact information
Practice address
343 E 4TH N STE 233, REXBURG, ID 83440-6009
(208) 715-6709
Mailing address
343 E 4TH N STE 233, REXBURG, ID 83440-6009
(208) 715-6709
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/06/2021
Last updated
02/06/2026
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