Coeur D'Alene Wigs LLC

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

COEUR D'ALENE WIGS LLC

Practice address

296 W Sunset Ave Ste 17
Coeur D Alene, ID 83815-8367

Phone

(208) 551-2761

NPI assigned

Jun 30, 2021

Last updated

Jun 30, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jennifer Lynn Lindley

Title

Owner/Partner

Phone

(208) 551-2761

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1558931691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1073",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351073",
            "telephone_number": "208-651-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 W SUNSET AVE STE 17",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158367",
            "telephone_number": "208-551-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COEUR D'ALENE WIGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "LINDLEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "208-551-2761",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Prosthetist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.