KRISTA TICKEMYER FNP
Individual Provider (NPI-1)
Active
Nurse Practitioner
Provider Information
- NPI Number
1114393618- Provider Type
- Individual Provider (NPI-1)
- Credentials
- FNP
- Status
- Active
Contact & Location
- Address
- 1919 LINCOLN WAY STE 415, COEUR D ALENE, ID, 83814
- Phone
- (208) 625-4595
- Fax
- (208) 625-4596
Specialties & Taxonomies
Registered Nurse
License: ID #N-35924
Nurse Practitioner, Family
License: ID #NP-1596A
Nurse Practitioner
Primary License: ID #N-40239