Individual
NICOLE W PELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5085
(208) 625-5731
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Taxonomy
Speciality
Code
Description
License number
State
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
Primary
M-13281
ID
Other
Enumeration date
10/17/2006
Last updated
10/06/2020
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