Healthcare Provider Details

I. General information

NPI: 1437405966
Provider Name (Legal Business Name): KATIE M SWEENEY-AMOREBIETA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE M SWEENEY NP

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 ONTARIO ST
SANDPOINT ID
83864-1786
US

IV. Provider business mailing address

1555 ONTARIO ST
SANDPOINT ID
83864-1786
US

V. Phone/Fax

Practice location:
  • Phone: 208-597-7910
  • Fax: 208-597-7909
Mailing address:
  • Phone: 208-597-7910
  • Fax: 208-597-7909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-1211A
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: