| Laci Ann Burk, FNP-BC | |
|
423 N 3rd Ave Ste 210, Sandpoint, ID 83864-1511 | |
| (208) 263-2173 | |
| Not Available |
| Full Name | Laci Ann Burk |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 423 N 3rd Ave Ste 210, Sandpoint, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588912836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | NUR-RN-LIC-34875 (Montana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | NP-1723A (Idaho) | Primary |
| Entity Name | Bonner General Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154563963 PECOS PAC ID: 4082690466 Enrollment ID: O20040626000014 |
| Mailing Address | Practice Location Address |
|---|---|
| Laci Ann Burk, FNP-BC 520 N 3rd Ave, Sandpoint, ID 83864-1507 Ph: (208) 263-1441 | Laci Ann Burk, FNP-BC 423 N 3rd Ave Ste 210, Sandpoint, ID 83864-1511 Ph: (208) 263-2173 |
Ms. Ann L Cox, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 810 N. Sixth Avenue, Sandpoint, ID 83864 Phone: 208-265-2242 Fax: 208-265-8214 | |
Erin Bass, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 810 N. Sixth Avenue, Sandpoint, ID 83864 Phone: 208-265-2242 Fax: 208-265-8214 | |
Kimberly Amelia Rutland, WHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 810 Sixth Ave, Sandpoint, ID 83864 Phone: 208-265-6252 Fax: 208-265-8214 | |
Tammy Lynn Undiemi, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 810 Sixth Ave, Sandpoint, ID 83864 Phone: 208-263-3410 Fax: 208-255-4842 | |
Natasha M Splaine-talbott, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 606 N 3rd Ave Ste 203, Sandpoint, ID 83864 Phone: 304-276-9937 | |
Denise White, DNP, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 606 N Third Ave Ste 203, Sandpoint, ID 83864 Phone: 208-265-1046 Fax: 208-265-3756 | |
Anna Mena-schaures, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1013 Lake St Ste 102, Sandpoint, ID 83864 Phone: 208-597-7910 |