Jennifer Marie Beaulieu
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Payette, ID
NPI 1477258341 · NPPES record last updated Jan 13, 2026
Key facts
- NPI
- 1477258341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 75717 (ID)
- Practice address
- 1441 NE 10TH Ave
Payette, ID 83661-5420 - Phone
- (208) 642-9376
- Fax
- (208) 642-9598
- NPI assigned
- Mar 31, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Valley Family Health Care Inc
Practice addresses (Care Compare)
1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376
2327 SW 4TH Ave
Unit 3
Ontario, OR 97914-1851
Phone (541) 889-2340
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230606003033 | ID | Practitioner - Nurse Practitioner | 6305203365 | Reassigns benefits to 1 organization |
| I20240501003625 | OR | Practitioner - Nurse Practitioner | 6305203365 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10007694 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Family Health Care Inc | Current |
Accepting new patients | |
| Valley Family Health Care, Inc | Current |
Accepting new patients | |
| Valley Family Health Care, Inc | Current | Accepting new patients | |
| Valley Family Health Care, Inc | Past | Accepting new patients | |
| Valley Family Health Care, Inc | Past | Accepting new patients |
Locations
207 E 12th St
Emmett, ID 83617
Phone (208) 365-1065
1441 NE 10th Ave
Payette, ID 83661
Phone (208) 642-9376
17 S 3rd St
Nyssa, OR 97913
Phone (541) 372-5738
896 Fortner St
Ontario, OR 97914
Phone (541) 709-2038
2327 SW 4th Ave
Unit 3
Ontario, OR 97914
Phone (541) 889-2340
2327 SW 4th Ave
Ste 1
Ontario, OR 97914
Phone (541) 889-2340
789 Washington St W
Vale, OR 97918
Phone (503) 473-2101
Interoperability endpoints
- jbeaulieu644302@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10007694 | OR | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 75717 | ID | Yes |
Addresses
Primary practice location
1441 NE 10TH Ave
Payette, ID 83661-5420
Mailing address
1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500819945 | Medicaid | OR |
Other names
- Jennifer Crain
Other providers in Payette, ID
- Alpine Family Corporation
- Alumira Counseling LLC
- Dena Ann Baldwin
- Ben Barbot
- Juli A Bardsley
- Keri Lyn Bennett
- Kacie Benson
- Destinee Jo Blamires
- Albion E. Borgholthaus
- Abigail Bradford
All providers in Payette, ID · Psychiatric/Mental Health Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.