Individual provider · Type 1 NPI

Krista Tickemyer, FNP

Nurse Practitioner · Coeur D Alene, ID

NPI number 1114393618 Active

Practice location

1919 Lincoln Way Ste 415
Coeur D Alene, ID 83814

Call (208) 625-4595 Map

Fax (208) 625-4596

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Other practice locations

1090 W. Park Place, Coeur D'alene, ID 83814 · (208) 292-0292

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	N-35924 (ID)
Family Nurse Practitioner	363LF0000X	NP-1596A (ID)
Nurse Practitioner Primary	363L00000X	N-40239 (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 1114393618

Krista Tickemyer, FNP's National Provider Identifier is 1114393618, issued on Aug 19, 2015. 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 Jul 25, 2025.