Healthcare Provider Details

I. General information

NPI: 1518895127
Provider Name (Legal Business Name): KATHRYN K CALKINS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 THAIN RD STE A
LEWISTON ID
83501-6230
US

IV. Provider business mailing address

806 20TH ST
LEWISTON ID
83501-3175
US

V. Phone/Fax

Practice location:
  • Phone: 208-848-6115
  • Fax:
Mailing address:
  • Phone: 208-848-6115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2381202
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: