MS. DEBRA COLLEEN MYKKANEN FNP NPI 1548346935

NPI Information

NPI: 1548346935
Provider Name: MS. DEBRA COLLEEN MYKKANEN, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
700 W IRONWOOD DR
SUITE 155
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 667-0585
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MS. Debra Colleen Mykkanen, FNP is a family nurse practitioner in Coeur D Alene, ID. MS. Debra Colleen Mykkanen, FNP NPI is 1548346935. 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:

700 W IRONWOOD DR
SUITE 155
COEUR D ALENE, ID
ZIP 83814-656
Phone: (208) 667-0585
Fax: (208) 667-0876

The enumeration date for this NPI number is 10/27/2006 and was last updated on 12/18/2013.

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	NP306A	IDAHO	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	9645896	MEDICAID	WASHINGTON
2	1548346935	MEDICAID	MONTANA
3	000010016720	OTHER	IDAHO	REGENCE BLUE SHIELD
4	NPPR4	OTHER	IDAHO	BLUE CROSS OF IDAHO
5	000010016721	OTHER	IDAHO	REGENCE BLUE SHIELD
6	NPKN7	OTHER	IDAHO	BLUE CROSS
7	NP772ID	MEDICAID	ALASKA
8	004376300	MEDICAID	IDAHO

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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