IndividualActive
Blake Mcdonald, PMHNP
NPI 1396379475 · Psychiatric/Mental Health Nurse Practitioner · Caldwell, ID
Provider details
- NPI number
- 1396379475
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PMHNP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 63996 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1906 Fairview Ave Ste 220
Caldwell, ID 83605-5432
Phone: (208) 795-5072
Fax: (208) 402-0068
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 277976
Atlanta, GA 30384-7976
Registry dates
- Enumerated
- 2020-02-27
- Last updated
- 2020-04-21
- Certified
- 2020-04-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.