Provider Demographics
NPI:1417356213
Name:FICEK, BRITTANY T (FNP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:T
Last Name:FICEK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-6000
Mailing Address - Fax:208-625-6001
Practice Address - Street 1:1919 LINCOLN WAY
Practice Address - Street 2:315
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2527
Practice Address - Country:US
Practice Address - Phone:208-625-6000
Practice Address - Fax:208-625-6001
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1483A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner