Provider Demographics
NPI:1669779955
Name:ASPER, ANNETTE L (DNP)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:L
Last Name:ASPER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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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:208-625-3800
Mailing Address - Fax:208-625-3801
Practice Address - Street 1:2288 N MERRITT CREEK LOOP STE 200
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4992
Practice Address - Country:US
Practice Address - Phone:208-625-3800
Practice Address - Fax:208-625-3801
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1037A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1669779955Medicaid
P00864225OtherRAILROAD MEDICARE
P00864225OtherRAILROAD MEDICARE