Individual
LACI ANN BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
423 N 3RD AVE STE 210, SANDPOINT, ID 83864-1511
(208) 263-2173
Mailing address
520 N 3RD AVE, SANDPOINT, ID 83864-1507
(208) 263-1441
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1723A
ID
363LF0000X
Family Nurse Practitioner
NUR-RN-LIC-34875
MT
Other
Enumeration date
08/16/2012
Last updated
10/29/2024
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