North Idaho Wound Care PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

NORTH IDAHO WOUND CARE PLLC

Practice address

3906 W Calzado Dr
Coeur D Alene, ID 83815-5161

Phone

(208) 518-9193

NPI assigned

Feb 16, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Rae Stallings, ARNPNPI 1780253989

Title

Member

Phone

(208) 518-9193

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Rae Stallings, NP

  • Nurse Practitioner
  • Coeur d'Alene, ID
  • NPI 1780253989
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1932052529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 W CALZADO DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838155161",
            "telephone_number": "208-518-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 W CALZADO DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838155161",
            "telephone_number": "208-518-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IDAHO WOUND CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "STALLINGS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "208-518-9193",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Idaho Psychiatry LLC
• North Idaho Ranch Recovery Clinic
• North Idaho Treatment Associates
• North Idaho Urology, PLLC
• North Idaho Weight Loss, LLC.
• North Lakes Family Center
• North Star Child Development Center
• Northwest Behavioral Healthcare
• Northwest Behavioral Life Skills
• Northwest Counseling LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.