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General NPI Number Information
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NPI Number | 1104896075
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Entity Type | Individual
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Provider Name | REGINA MILLER PRINDLE NP
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3700 W SELTICE WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814-8921
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Country | US
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Telephone | 208-620-5255
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Fax | 844-807-3782
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Provider Business Mailing Address
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Address Line | PO BOX 1387
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City | HAYDEN
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State | ID
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Zip | 83835-1387
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Country | US
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Telephone | 208-415-0299
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Fax | 208-625-2070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 473A
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License Number State | ID
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