Provider Demographics
NPI:1487999850
Name:LAPLANTE, JESSICA LYN (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYN
Last Name:LAPLANTE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 N BIZTOWN LOOP
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-5044
Mailing Address - Country:US
Mailing Address - Phone:208-635-5265
Mailing Address - Fax:208-635-5218
Practice Address - Street 1:8382 N WAYNE DR STE 204
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-6028
Practice Address - Country:US
Practice Address - Phone:208-635-5265
Practice Address - Fax:208-635-5218
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1486A363L00000X
WAAP60325372363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner