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NPI Code Detail

MEDICARE: KRISTY HANDYSIDE APRN, WCC

MEDICARE: KRISTY HANDYSIDE APRN, WCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner61427ID
2363L00000XNurse Practitioner234790MT
3363LF0000XFamily Nurse PractitionerAP61475074WA

General Provider Information

NPI Number : 1437715208
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTY HANDYSIDE APRN, WCC
Provider Business Mailing Address
First Line : 10524 W THOMPSON RD
Second Line :
City : COEUR D ALENE
State : ID
Zip : 83814-7157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1525 ADDISON AVE E STE A2
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-5300
Country : US
Telephone Number : 877-223-8007
Fax Number : 661-725-5252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2019
Last Update Date : 09/25/2024

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Directions to “ KRISTY HANDYSIDE APRN, WCC” Practice Location

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