Healthcare Provider Details

I. General information

NPI: 1710818059
Provider Name (Legal Business Name): KIDCIERGE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 S RICHARDS RD
POST FALLS ID
83854-4863
US

IV. Provider business mailing address

271 S RICHARDS RD
POST FALLS ID
83854-4863
US

V. Phone/Fax

Practice location:
  • Phone: 509-998-8210
  • Fax:
Mailing address:
  • Phone: 509-998-8210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AUBREY BOT
Title or Position: OWNER/PROVIDER
Credential: ARNP
Phone: 509-998-8210