Individual
SYDNEY ELIZABETH DISSELKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
700 W IRONWOOD DR STE 378, COEUR D ALENE, ID 83814-4401
(208) 625-3555
(208) 769-8616
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
63540
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023604089
—
ID
Enumeration date
12/14/2020
Last updated
04/14/2025
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