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Individual

CARMEN R STOLTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 746-1383
(208) 746-6348

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP30007156
WA
363LF0000X
Family Nurse Practitioner
Primary
NP490A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0174747
WA LABOR & INDUSTRIES
WA
05
1016718
WA
01
1699858415
REGENCE BLUESHIELD
ID
05
1699858415
ID
01
NPN6
BC/ID
ID
01
P00270115
RR MEDICARE
ID
Enumeration date
10/23/2006
Last updated
03/07/2016
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