Healthcare Provider Details

I. General information

NPI: 1215485503
Provider Name (Legal Business Name): NATALYA ALEKHINA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W IRONWOOD DR STE 130
COEUR D ALENE ID
83814
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 208-625-4700
  • Fax: 208-625-4701
Mailing address:
  • Phone: 208-625-4700
  • Fax: 208-625-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN61270
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP61270
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: