Individual
LYDA ERIN NICODEMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9631 N NEVADA ST STE 300, SPOKANE, WA 99218-1193
(509) 465-3919
(509) 795-0895
Mailing address
601 S SHERMAN ST # 201, SPOKANE, WA 99202-1311
(509) 473-0885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61025822
WA
Other
Enumeration date
06/15/2020
Last updated
09/14/2021
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