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Individual

LISA R KAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, APRN, FNP-BC

Contact information

Practice address
3400 E FERNAN HILL RD, COEUR D ALENE, ID 83814-7588
(208) 819-2183
Mailing address
3400 E FERNAN HILL RD, COEUR D ALENE, ID 83814-7588
(208) 819-2183

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
071833623
NH
363LF0000X
Family Nurse Practitioner
Primary
68388
ID
363LF0000X
Family Nurse Practitioner
RN2337812
MA

Other

Enumeration date
08/23/2020
Last updated
09/15/2021
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