Most Relevant Information
Provider Data
| NPI Number: | 1003201138 |
| Provider Name: | DEBORAH MAGNUSON APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | CNP3754 |
Most Important Dates
| Enumeration Date: | 04/06/2015 |
| Last Updated: | 02/10/2023 |
Provider Practice Location
1090 W PARK PL
COEUR D ALENE
ID
838142785
Practice Location Phone/Fax
| Phone: | 2082152005 |
| Fax: | 8448073782 |
Provider Mailing Location
PO BOX 1387
HAYDEN
ID
838351387
Provider Mailing Phone/Fax
| Phone: | 2084150299 |
| Fax: |