Search › Idaho › 363L00000X
Krista Tickemyer, FNP
NPI 1114393618 · on the registry since 2015
Practice
- Address
- 1919 Lincoln Way Ste 415
Coeur D Alene, ID 83814 - Phone
- (208) 625-4595
- Fax
- (208) 625-4596
- Clinicians at this address
- 63
Additional practice sites
- 1090 W. Park Place, Coeur D'Alene, ID
Registry record
- Primary taxonomy
- 363L00000X
363L00000X
- Also registered as
- 163W00000X
363LF0000X - Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-07-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho