Healthcare Provider Details

I. General information

NPI: 1750682605
Provider Name (Legal Business Name): KELLY A. FUHRMAN ARNP FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 HIGHWAY 2
SANDPOINT ID
83864
US

IV. Provider business mailing address

203 N WASHINGTON ST STE 300
SPOKANE WA
99201-0233
US

V. Phone/Fax

Practice location:
  • Phone: 208-290-3302
  • Fax:
Mailing address:
  • Phone: 509-444-8888
  • Fax: 509-444-7806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60184677
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: