MEDICARE: AMI ALISA CURRIE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	58781	ID

General Provider Information

NPI Number	:	1013698026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMI ALISA CURRIE RN

Provider Business Mailing Address
First Line	:	1498 E WARM SPRINGS AVE
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-4974
Country	:	US
Telephone Number	:	208-964-3468
Fax Number	:

Provider Business Practice Location Address
First Line	:	1498 E WARM SPRINGS AVE
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-4974
Country	:	US
Telephone Number	:	208-964-3468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	10/31/2023

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