Desiree Creekmore
Nurse Practitioner in Coeur D Alene, ID. Individual provider (NPI-1).
NPI number1639748890
StatusActive
Last updated in NPPESAug 5, 2025
Details
- NPI
- 1639748890
- Entity type
- Individual (NPI-1)
- Name
- Desiree Creekmore
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 22, 2021
- Certification date
- Aug 5, 2025
- Last updated
- Aug 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71988 | ID | Yes |
| 363LA2100X | Nurse Practitioner, Acute Care | AP61145770 | WA | |
| 363LA2100X | Nurse Practitioner, Acute Care | 71988 | ID |
Practice location
2003 Kootenai Health WayCoeur D Alene, ID 83814-6051
Phone 208-625-6754
Mailing address
2003 Kootenai Health WayCoeur D Alene, ID 83814-6051
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