Individual provider · Type 1 NPI
Vadim P. Pustynovich, FNP-C
Family Nurse Practitioner · Coeur D Alene, ID
NPI number
1518507086
Active
Practice location
700 W Ironwood Dr Ste 120
Coeur D Alene, ID 83814-4405
Fax (208) 625-3645
Mailing address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ01002700 (NJ) |
| Family Nurse Practitioner Primary | 363LF0000X | NP66228 (ID) |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1518507086
Vadim P. Pustynovich, FNP-C's National Provider Identifier is 1518507086, issued on Jan 13, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Coeur D Alene, ID. The record was last updated on Apr 24, 2024.