Individual
LISA L KALTENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
307 SAINT JOHNS WAY STE 1, LEWISTON, ID 83501-2435
(208) 746-5132
(208) 746-0087
Mailing address
307 SAINT JOHNS WAY STE 1, LEWISTON, ID 83501-2435
(208) 746-5132
(208) 746-0087
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
16540
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010135951
BLUE SHIELD
ID
01
—
32268
BLUE CROSS
ID
Enumeration date
10/03/2006
Last updated
08/19/2010
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