Provider Demographics
NPI:1528705647
Name:CONSIDINE, EVELYN BORROMEO (NP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:BORROMEO
Last Name:CONSIDINE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25043 N LANTERN HILL RD
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-8752
Mailing Address - Country:US
Mailing Address - Phone:229-561-2401
Mailing Address - Fax:208-625-6101
Practice Address - Street 1:KOOTENAI CLINIC NEPHROLOGY 700 W. IRONWOOD DR.
Practice Address - Street 2:STE. 375
Practice Address - City:COEUR D'ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-625-6100
Practice Address - Fax:208-625-6101
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID68494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily