Provider Demographics
NPI:1801389770
Name:SPIESS, ALICIA JEANNINE (ARNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:JEANNINE
Last Name:SPIESS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 N HOWARD ST # B
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8170
Mailing Address - Country:US
Mailing Address - Phone:208-930-4177
Mailing Address - Fax:
Practice Address - Street 1:2775 N HOWARD ST # B
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8170
Practice Address - Country:US
Practice Address - Phone:208-930-4177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60864439363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics