Provider Demographics
NPI:1104191089
Name:SPLAINE-TALBOTT, NATASHA M (PMHNP)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:M
Last Name:SPLAINE-TALBOTT
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1716
Mailing Address - Country:US
Mailing Address - Phone:304-276-9937
Mailing Address - Fax:
Practice Address - Street 1:606 N 3RD AVE STE 203
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1691
Practice Address - Country:US
Practice Address - Phone:304-276-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP1322A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health