Organization
MINDFUL MOMENTS PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRIE PETECH PMHNP-BC (OWNER/PRESCRIBER)
(509) 703-0736
Entity
Organization
Contact information
Practice address
270 W GEORGIA AVE STE 107, NAMPA, ID 83686-2835
(509) 703-0736
Mailing address
708 N HORTON ST, NAMPA, ID 83651-1936
(509) 703-0736
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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