Healthcare Provider Details

I. General information

NPI: 1922729656
Provider Name (Legal Business Name): CASSY ELBERTA MARGART LESTER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 W CANFIELD AVE
COEUR D ALENE ID
83815-9764
US

IV. Provider business mailing address

1304 N MALVERN RD
LIBERTY LAKE WA
99019-8590
US

V. Phone/Fax

Practice location:
  • Phone: 208-758-0560
  • Fax:
Mailing address:
  • Phone: 509-599-5762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number9681307
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number61354759
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: