MANDI NORDHAGEN (NPI# 1063944726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063944726 |
| Entity Type | Individual |
| Full Name | MANDI NORDHAGEN |
| Practice Address |
700 W Ironwood Dr Suite 228 Coeur D Alene ID 83814-2656 |
| Practice Telephone | 2086255670 |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
PH00039410 | WA | Pharmacy Service Providers |
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
P6493 | ID | Pharmacy Service Providers |
| Street Address |
700 W IRONWOOD DR SUITE 228 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771451 | Ronald J Stout | Otolaryngology | 700 W Ironwood Dr, Ste 236, Coeur D Alene, ID 83814-4484 | 2005-06-24 |
| 1033635180 | Jamie Lee Park | Pharmacist | 700 W Ironwood Dr, Coeur D Alene, ID 83814-2656 | 2017-08-21 |
| 1679004675 | Jamie Cervi-skinner | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-22 |
| 1982144424 | Carissa Hober | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-02 |
| 1861939910 | Kellie Kathryn Breaux | Nurse Practitioner | 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 | 2017-01-27 |
| 1902348709 | Michael Watrobka | Physician Assistant | 700 W Ironwood Dr, Suite 120e, Coeur D Alene, ID 83814-2656 | 2016-11-09 |
| 1841748530 | Elizabeth St John | Physician Assistant | 700 W Ironwood Dr, Ste 341, Coeur D Alene, ID 83814-2656 | 2016-09-12 |
| 1184076465 | Craig Allred | Audiologist | 700 W Ironwood Dr, Ste 278, Coeur D Alene, ID 83814-2656 | 2016-07-11 |
| 1962869008 | Natalie Jeane Bartell | Nurse Practitioner | 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 | 2016-01-20 |
| 1437553187 | Gretchen Foley | Physician Assistant | 700 W Ironwood Dr, 320, Coeur D Alene, ID 83814-2656 | 2014-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679004675 | Jamie Cervi-skinner | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-22 |
| 1982144424 | Carissa Hober | Pharmacist | 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 | 2017-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528575453 | Joshua Todd Bishop | Pharmacist | 4715 W Deer Path Dr, Boise, ID 83714-8873 | 2017-12-31 |
| 1851944151 | Catherine Smith | Pharmacist | 500 W Fort St, Boise, ID 83702-4501 | 2019-07-17 |
| 1043873995 | John Bronsell Ryan Bronsell | Pharmacist | 427 12th St, Plummer, ID 83851-4000 | 2019-04-16 |
| 1962965194 | Leanne Elizabeth Ertle | Pharmacist | 500 W Fort St, Boise, ID 83702-4501 | 2019-04-14 |
| 1750843579 | Joshua Joseph Davis | Pharmacist | 714 N College Rd Ste A, Twin Falls, ID 83301-5812 | 2019-04-01 |
| 1952825325 | Nicholas Jordan Wood | Pharmacist | 6565 W Emerald St, Boise, ID 83704-8737 | 2017-07-27 |
| 1124470794 | Colt Darley | Pharmacist | 103 E College Ave, St Maries, ID 83861-2247 | 2016-07-07 |
| 1679923585 | Mark Romer | Pharmacist | 1600 N Main St, Meridian, ID 83642-1709 | 2016-06-21 |
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on MANDI NORDHAGEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.