Healthcare Provider Details

I. General information

NPI: 1093494601
Provider Name (Legal Business Name): AIMEE M GOOLD ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 W IRONWOOD DR STE 200
COEUR D ALENE ID
83814-2643
US

IV. Provider business mailing address

PO BOX 2021
VERADALE WA
99037-2021
US

V. Phone/Fax

Practice location:
  • Phone: 208-667-2600
  • Fax: 208-625-2051
Mailing address:
  • Phone: 509-939-8253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number72171
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61425714
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: