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Individual

MR. ROBERT EVERETT LEETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP, PMHNP

Contact information

Practice address
909 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 292-4006
(866) 229-7081
Mailing address
909 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 292-4006
(866) 229-7081

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19136
OH
363LF0000X
Family Nurse Practitioner
23345
CA
363LF0000X
Family Nurse Practitioner
897
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19136
OH

Other

Enumeration date
04/07/2006
Last updated
04/02/2024
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