Healthcare Provider Details

I. General information

NPI: 1063761807
Provider Name (Legal Business Name): ERIKA L SARGENT N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 NORTHWEST BLVD STE 104
COEUR D ALENE ID
83814-5605
US

IV. Provider business mailing address

1450 NORTHWEST BLVD STE 104
COEUR D ALENE ID
83814-5605
US

V. Phone/Fax

Practice location:
  • Phone: 619-517-7403
  • Fax: 888-686-5561
Mailing address:
  • Phone: 619-517-7403
  • Fax: 888-686-5561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2082
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number704622
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number78940
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number78940
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: