OrganizationActive
Portneuf River Center
NPI 1518006113 · Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist · Pocatello, ID
Provider details
- NPI number
- 1518006113
- Entity type
- Organization
- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Kathleen Werner-Leap, Director(208) 233-2998
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
427 N Arthur Ave Ste B
Pocatello, ID 83204-3006
Phone: (208) 233-2998
Fax: (208) 232-0881
Approximate (ZIP-level) locationGet directions
Mailing address
427 N Arthur Ave Ste B
Pocatello, ID 83204-3006
Registry dates
- Enumerated
- 2007-02-06
- Last updated
- 2008-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.