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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JEREMY ROBERT NICOLARSEN, MD

Active

DR. JEREMY ROBERT NICOLARSEN, MD is a Pediatric Cardiology healthcare provider located in COEUR D ALENE, Idaho. NPI 1891946778 is currently active in the NPPES registry. Verify at CMS.

Pediatric Cardiology · COEUR D ALENE, ID

Registration Details

NPI Number
1891946778
Provider Type
Individual
Gender
Male
NPI Issued
Oct 9, 2008 (17.872026715015 yrs)
Last Updated
Oct 2, 2020
License
M13579 (ID)

Practice Information

Address
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID, 838146051
Browse ID providers · Browse ZIP 83814
Phone
2086254000
Primary Specialty
Pediatric Cardiology
2080P0202X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.