Healthcare Provider Details

I. General information

NPI: 1760345193
Provider Name (Legal Business Name): COMPASS FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W SUNSET AVE
COEUR D ALENE ID
83815-8305
US

IV. Provider business mailing address

214 W SUNSET AVE
COEUR D ALENE ID
83815-8305
US

V. Phone/Fax

Practice location:
  • Phone: 509-993-0762
  • Fax:
Mailing address:
  • Phone: 208-758-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LYNN BAXTER
Title or Position: NURSE PRACTITIONER/CO-FOUNDER
Credential: ARNP
Phone: 208-758-7878