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

Gen State Integrative Medicine

Organization Family Medicine Physician · NPI 1790609477

Gen State Integrative Medicine is a Family Medicine Physician in Meridian, Idaho. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

1500 E Heritage Park Ln Ste 150 Ste 150
Meridian, ID 83646
Phone: (208) 202-7247
Fax: (208) 202-7246
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1790609477
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Petrie — Owner/President · (208) 365-7131
NPI enumeratedAugust 6, 2026
Last updated in NPPESAugust 6, 2026
Mailing address1500 East Heritage Park Lane, Suite 150, Suite 150, Meridian, ID 83646

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