MS. JANA M QUALLS FNP NPI 1083670889

NPI Information

NPI: 1083670889
Provider Name: MS. JANA M QUALLS, FNP
Classification: Nurse Practitioner - 363LC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

Organization: RATHDRUM CLINIC INC

PECOS Registration: Yes

Address:
1090 W PARK PL
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 292-0641
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MS. Jana M Qualls, FNP is a critical care medicine nurse practitioner in Coeur D Alene, ID with 24 years of experience. MS. Jana M Qualls, FNP NPI is 1083670889. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1090 W PARK PL
COEUR D ALENE, ID
ZIP 83814-785
Phone: (208) 292-0641
Fax: (208) 667-6547

The NPI 1083670889 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 10/13/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	NP-1631A	IDAHO	No
2	363LC0200X	Nurse Practitioner	Critical Care Medicine	7267	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P43486	MEDICARE UPIN	TENNESSEE
2	3909774	MEDICARE ID-TYPE UNSPECIFIED		TN MEDICARE
3	P43486	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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