Individual
JARED PETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814
(208) 625-4870
(208) 625-4878
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5059
(208) 625-5731
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
357288-4408
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP60612
ID
Other
Enumeration date
07/30/2006
Last updated
05/01/2024
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