Provider Demographics
NPI:1023617347
Name:FOLLGER, KRISTINA MARIE (FNP)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:MARIE
Last Name:FOLLGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:KRISTINA
Other - Middle Name:MARIE
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:980 W IRONWOOD DR STE 302
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2668
Mailing Address - Country:US
Mailing Address - Phone:208-292-5437
Mailing Address - Fax:208-292-5441
Practice Address - Street 1:980 W IRONWOOD DR STE 302
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2668
Practice Address - Country:US
Practice Address - Phone:208-292-5437
Practice Address - Fax:208-292-5441
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID66042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily