DIAMOND TIEA FERN COURVILLE

COLVILLE, WA
NPI1770074478
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: WA  AP61591647)
Additional Taxonomies163W00000X Registered Nurse
(Licence: MT  75755)
363LP2300X Nurse Practitioner, Primary Care
(Licence: MT  NUR-APRN-LIC-239199)
Enumeration Date2018-05-29
Last Update Date2024-09-27
Business Address
DIAMOND TIEA FERN COURVILLE APRN- FNP-C
143 GARDEN HOMES DR
COLVILLE, WA 99114-9229
Phone number: 509-684-3701
Mailing Address
DIAMOND TIEA FERN COURVILLE APRN- FNP-C
PO BOX 421
LIBERTY LAKE, WA 99019-0421
Phone number: