Healthcare Provider Details

I. General information

NPI: 1437071651
Provider Name (Legal Business Name): LB MEDICAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 E MAPLE ST STE E
HAILEY ID
83333-4900
US

IV. Provider business mailing address

704 2ND AVE N
TWIN FALLS ID
83301-5746
US

V. Phone/Fax

Practice location:
  • Phone: 208-207-9422
  • Fax: 208-269-5828
Mailing address:
  • Phone: 208-207-9422
  • Fax: 208-269-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NICOLE DAWN BARTLETT
Title or Position: CO-OWNER
Credential: DNP, PMHNP-BC, AGACN
Phone: 208-207-9422