Individual
MS. TWYLA JEAN MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
850 W IRONWOOD DR STE 300, COEUR D ALENE, ID 83814-4903
(208) 457-7078
(208) 457-7079
Mailing address
25201 N MCCOY RD, ATHOL, ID 83801-8667
(208) 659-9234
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
15400
ID
363L00000X
Nurse Practitioner
Primary
NP-471A
ID
363LF0000X
Family Nurse Practitioner
NP-471A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366548661
—
ID
Enumeration date
09/15/2006
Last updated
11/11/2024
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