Individual
REGINA MARIE KENDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1686 W RIVERSTONE DR, COEUR D ALENE, ID 83814-5779
(208) 762-0480
(866) 573-0853
Mailing address
1686 W RIVERSTONE DR, COEUR D ALENE, ID 83814-5779
(208) 762-0480
(866) 573-0853
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-1460A
ID
364SF0001X
Family Health Clinical Nurse Specialist
AP60477652
WA
Other
Enumeration date
07/16/2014
Last updated
03/14/2023
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