Individual
TIANA JESPERSEN NIZAMIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 W IRONWOOD DR STE 375, COEUR D ALENE, ID 83814-4401
(208) 625-6100
(208) 625-6101
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-6100
(208) 625-6101
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
M-15908
ID
Other
Enumeration date
04/16/2015
Last updated
05/01/2024
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