High Tide Psychiatry, Pllc
NPI #1023762119 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1023762119
- Entity Type
- Organization
- Organization Name
- High Tide Psychiatry, Pllc
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Feb 8, 2022
- Last Updated
- Feb 8, 2022
Practice Location
- Address
- 1500 PANCHERI DR STE 4
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83402-3212
- Phone
- (208) 557-3870
Authorized Official
- Name
- AMBER JANE VAN SICKLE-BIRCH, PMHNP
- Title
- OWNER
- Phone
- (208) 557-3870
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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