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

Individual provider Family Nurse Practitioner · NPI 1871165118

Jennifer Wicklund, FNP-C is a Nurse Practitioner in Meridian, Idaho. Qualified in 2021, 5 years ago. Practices with Mountain Pine Dermatology PLLC, a 10-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2021
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

4664 N Penngrove Way Ste 100
Meridian, ID 83646-7442
Phone: (208) 898-7467
Fax: (208) 398-2120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704278431 (MI)

Record details

NPI number1871165118
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJuly 15, 2021
Last updated in NPPESFebruary 22, 2024
Certification dateSeptember 7, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mountain Pine Dermatology Pllc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Meridian