Organization · Type 2 NPI
Lifespan Wellness PLLC
Psychiatric/Mental Health Nurse Practitioner · Meridian, ID
NPI number
1366819310
Active
Practice location
1404 N Main St, Suite 101
Meridian, ID 83642-2799
Fax (208) 906-2363
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | NP-1536A (ID) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1366819310
Lifespan Wellness PLLC's National Provider Identifier is 1366819310, issued on Aug 25, 2015. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Meridian, ID. The record was last updated on Feb 24, 2016.