| Doctor Name: | REGINA MILLER PRINDLE |
| NPI Number: | 1104896075 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D., FNP |
| License Number: | 473A |
| Business Practice Address: | 14775 N Kimo Ct Rathdrum, ID - 838588762 |
| Business Phone Number: | 2086875627 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2583, COEUR D ALENE |
| State: | ID |
| Postal Code: | 838162583 |
| Phone Number: | 2087559432 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2006 |
| NPI Last Update Date: | 07/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 473A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |