Healthcare Provider Details

I. General information

NPI: 1932403524
Provider Name (Legal Business Name): JAMI KRIETZMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2010
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5944 W DIAGONAL RD
RATHDRUM ID
83858-8098
US

IV. Provider business mailing address

5944 W DIAGONAL RD
RATHDRUM ID
83858-8098
US

V. Phone/Fax

Practice location:
  • Phone: 720-237-2602
  • Fax:
Mailing address:
  • Phone: 720-237-2602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN-195310
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License NumberRN-195310
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: