Mykkanen, Debra Colleen
Mykkanen, Debra Colleen is an individual health care provider with primary practice located at 700 W Ironwood Dr Suite 155, Coeur D Alene ID 83814-2656. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mykkanen, Debra Colleen can be contacted via phone (208) 667-0585.Contact Information
Primary practice address
700 W Ironwood Dr Suite 155
Coeur D Alene ID 83814-2656
Phone: (208) 667-0585
Fax: (208) 667-0876
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | NP306A | Idaho |
Profile Details
| NPI number | 1548346935 |
|---|---|
| LBN Legal business name | Mykkanen, Debra Colleen |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2006 |
| Last updated | Dec 18th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548346935 | NPPES |
| Montana | MEDICAID | 1548346935 | |
| Montana | Other | 000010016720 | |
| Montana | Other | 000010016721 | |
| Montana | MEDICAID | 004376300 | |
| Montana | MEDICAID | 9645896 | |
| Montana | Other | NPPR4 | |
| Montana | MEDICAID | NP772ID | |
| Montana | Other | NPKN7 |
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