GARNET STATE ENTERPRISES LLC
NPI 1184433005
Nurse Practitioner - Psychiatric/Mental Health in Hayden, ID

Active since January 06, 2025
2481 HALLEBERRY, HAYDEN, ID 83835(208) 518-9927 Get Directions Write a Review

NPPES record last updated: January 6, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Nurse Practitioner
  • Psychiatric/Mental Health

About GARNET STATE ENTERPRISES LLC

This page provides the complete NPI Profile along with additional information for Garnet State Enterprises Llc, a provider established in Hayden, Idaho operating as a Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1184433005 assigned on January 2025. The practitioner's primary taxonomy code is 363LP0808X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Peter Gordon Gourley Arnp (Psychiatric Nurse Practitioner)

NPI
1184433005 Verify this NPI
Provider Name
GARNET STATE ENTERPRISES LLC
Entity Type
Organization
Location Address
2481 HALLEBERRY HAYDEN, ID 83835
Location Phone
(208) 518-9927
Mailing Address
2481 HALLEBERRY HAYDEN, ID 83835
Mailing Phone
(208) 518-9927
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-06-2025
Last Update Date
01-06-2025
Code Navigator

A nurse practitioner (NP) like Garnet State Enterprises Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Psychiatric/Mental Health

Taxonomy Code
363LP0808X
Type
Physician Assistants & Advanced Practice Nursing Providers

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. PETER GORDON GOURLEY ARNP

Authorized Official Title
PSYCHIATRIC NURSE PRACTITIONER
Authorized Official Phone
(208) 518-9927

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184433005, enumerated as an "organization" on January 06, 2025.

The provider is located at 2481 HALLEBERRY HAYDEN, ID 83835 and the phone number is (208) 518-9927.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.