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General NPI Number Information
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NPI Number | 1073837472
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Entity Type | Individual
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Provider Name | JILL MARIE WHITE ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 3700 W SELTICE WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814-8921
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Country | US
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Telephone | 208-620-5255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1387
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City | HAYDEN
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State | ID
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Zip | 83835-1387
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60533440
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 23667
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP-1397A
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | N-29302
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 806071
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License Number State | CA
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