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General NPI Number Information
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NPI Number | 1538087077
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Entity Type | Individual
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Provider Name | SHARON L BISTODEAU RN
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Gender | Female
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 794 WILD TURKEY RD
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City | SANDPOINT
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State | ID
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Zip | 83864-9537
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Country | US
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Telephone | 208-265-2437
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Fax |
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Provider Business Mailing Address
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Address Line | 794 WILD TURKEY RD
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City | SANDPOINT
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State | ID
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Zip | 83864-9537
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Country | US
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Telephone | 208-265-2437
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Fax |
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | N-22449
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License Number State | ID
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