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General NPI Number Information
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NPI Number | 1184552994
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Entity Type | Organization
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Legal Business Name | ARROW FUNCTIONAL MEDICINE, PLLC.
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 2115 E SHERMAN AVE STE 105
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City | COEUR D ALENE
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State | ID
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Zip | 83814-5364
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Country | US
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Telephone | 208-444-1218
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Fax |
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Provider Business Mailing Address
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Address Line | 2115 E SHERMAN AVE STE 105
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City | COEUR D ALENE
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State | ID
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Zip | 83814-5364
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Country | US
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Telephone | 208-444-1218
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ROBERT TABARACCI
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Credential |
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Telephone | 406-240-4099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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