Individual
TARESA LYNN MICHNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3251
(208) 962-2313
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 962-3251
(208) 962-2313
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
54185
ID
363LF0000X
Family Nurse Practitioner
Primary
NP54185
ID
Other
Enumeration date
10/03/2016
Last updated
08/06/2021
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