Healthcare Provider Details

I. General information

NPI: 1760708044
Provider Name (Legal Business Name): FAITH MARIE KRULL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH MARIE SMART

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 W IRONWOOD DR STE 306
COEUR D ALENE ID
83814-2668
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 208-625-4970
  • Fax: 208-625-4991
Mailing address:
  • Phone: 208-625-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM-57A
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM-57A
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: