| Doctor Name: | JAMIE LYNN DANISH |
| NPI Number: | 1164786794 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | NP-1191A |
| Business Practice Address: | 14775 N Kimo Ct Ste B Rathdrum, ID - 838588762 |
| Business Phone Number: | 2086875627 |
| Business Fax Number: | 2086875628 |
| Mailing Address: | 14775 N Kimo Ct, Ste B RATHDRUM |
| State: | ID |
| Postal Code: | 838588762 |
| Phone Number: | 2086875627 |
| Fax Number: | 2086875628 |
| NPI Enumeration Date: | 06/28/2012 |
| NPI Last Update Date: | 06/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-1191A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |