Individual
MS. WHITNEY V LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
102 S. EUCLID AVE., SUITE 202, SANDPOINT, ID 83864-4939
(208) 263-6876
(208) 263-2033
Mailing address
PO BOX 550, SANDPOINT, ID 83864-0550
(855) 397-0197
(800) 272-6512
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201708936NP-PP
OR
363L00000X
Nurse Practitioner
57882
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200941379RN
OREGON STATE BOARD OF NURSING
OR
01
—
201708936NP-PP
OREGON STATE BOARD OF NURSING
OR
Enumeration date
09/28/2017
Last updated
08/20/2020
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