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General NPI Number Information
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NPI Number | 1740122647
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Entity Type | Organization
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Legal Business Name | MINDFUL HEALING PSYCHIATRY OF IDAHO
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 3006 E GOLDSTONE DR
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City | MERIDIAN
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State | ID
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Zip | 83642-1549
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Country | US
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Telephone | 208-614-4611
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Fax |
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Provider Business Mailing Address
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Address Line | 8377 E COPENHAVER ST
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City | NAMPA
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State | ID
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Zip | 83687-4824
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Country | US
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Telephone | 360-485-5500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH ANN PURCELL
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Credential | MSN, PMHNP
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Telephone | 208-614-4611
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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 |
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License Number State |
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