Healthcare Provider Details

I. General information

NPI: 1316881568
Provider Name (Legal Business Name): LEGACY CREEK WOMEN'S WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 PARKVIEW AVE
TWIN FALLS ID
83301
US

IV. Provider business mailing address

PO BOX 5937
TWIN FALLS ID
83303-5937
US

V. Phone/Fax

Practice location:
  • Phone: 208-358-0122
  • Fax:
Mailing address:
  • Phone: 208-358-0122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICA KATE BIGGS
Title or Position: OWNER
Credential: DNP
Phone: 208-358-0122