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General NPI Number Information
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NPI Number | 1750105367
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Entity Type | Individual
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Provider Name | NICHOLE J WALTERS PIEKARSKI MSN
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 3815 N SCHREIBER WAY UNIT 102
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City | COEUR D ALENE
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State | ID
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Zip | 83815-8434
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Country | US
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Telephone | 208-667-4557
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Fax | 208-765-2887
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Provider Business Mailing Address
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Address Line | 3815 N SCHREIBER WAY UNIT 102
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City | COEUR D ALENE
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State | ID
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Zip | 83815-8434
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Country | US
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Telephone | 208-667-4557
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Fax | 208-765-2887
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 34817
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License Number State | ID
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