Individual provider · Type 1 NPI

Stephen Gene Ployhar

Nurse Practitioner · Coeur D Alene, ID

NPI number 1104750371 Active

Practice location

1090 W Park Pl
Coeur D Alene, ID 83814-2785

Call (208) 415-0299 Map

Mailing address

PO Box 1387
Hayden, ID 83835-1387

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	2681314 (ID)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104750371

Stephen Gene Ployhar's National Provider Identifier is 1104750371, issued on Jun 11, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Coeur D Alene, ID. The record was last updated on Sep 10, 2026.