Healthcare Provider Details

I. General information

NPI: 1841376241
Provider Name (Legal Business Name): KRISTA S ADAMSON PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 04/09/2021
Certification Date: 03/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 N VERCLER RD BLDG 1
SPOKANE VALLEY WA
99216-1092
US

IV. Provider business mailing address

700 W IRONWOOD DR SUITE 155
COEUR D ALENE ID
83814-2656
US

V. Phone/Fax

Practice location:
  • Phone: 509-928-6383
  • Fax: 509-926-9420
Mailing address:
  • Phone: 208-667-0585
  • Fax: 208-667-0876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP562
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP60958277
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: