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General NPI Number Information
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NPI Number | 1760345193
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Entity Type | Organization
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Legal Business Name | COMPASS FAMILY PRACTICE
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 214 W SUNSET AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83815-8305
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Country | US
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Telephone | 509-993-0762
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Fax |
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Provider Business Mailing Address
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Address Line | 214 W SUNSET AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83815-8305
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Country | US
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Telephone | 208-758-7878
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/CO-FOUNDER
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Name | MICHELLE LYNN BAXTER
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Credential | ARNP
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Telephone | 208-758-7878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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