Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Functional Medicine of North Idaho, PLLC

Organization Clinic/Center · NPI 1750920401

Functional Medicine of North Idaho, PLLC is a Clinic/Center in Hayden, Idaho. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8382 N Wayne Dr Ste 204
Hayden, ID 83835-6028
Phone: (208) 635-5265
Fax: (208) 635-5218
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1750920401
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Laplante — Owner · (208) 635-5265
NPI enumeratedDecember 29, 2019
Last updated in NPPESJuly 1, 2024
Certification dateJuly 1, 2024
Mailing address1399 N Biztown Loop, Hayden, ID 83835-5044

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