Provider Demographics
NPI:1558943779
Name:LB MEDICAL CONSULTANTS
Entity Type:Organization
Organization Name:LB MEDICAL CONSULTANTS
Other - Org Name:H3OWELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AGACNP, PHMNP
Authorized Official - Phone:559-681-6000
Mailing Address - Street 1:704 2ND AVE N
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5746
Mailing Address - Country:US
Mailing Address - Phone:559-681-6000
Mailing Address - Fax:
Practice Address - Street 1:704 2ND AVE N
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5746
Practice Address - Country:US
Practice Address - Phone:208-207-9422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty