JARED PETRICK NPI 1932114618

NPI Information

  • NPI: 1932114618
  • Provider Name: JARED PETRICK
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2003 KOOTENAI HEALTH WAY
    COEUR D ALENE, ID
    ZIP 83814
  • Phone: (208) 625-4870

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NPI Details

Jared Petrick is a psychiatric/mental health nurse practitioner in Coeur D Alene, ID. Jared Petrick NPI is 1932114618. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 625-4870
Fax: (208) 625-4878

The NPI 1932114618 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 5/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health357288-4408UTAHNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthNP60612IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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