Michelle Poelstra

Individual provider Active NPI General Practice Registered Nurse · Ponderay, ID

NPI 1508716283 · NPPES record last updated Feb 2, 2026

Key facts

NPI
1508716283
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
1271146 (ID)
Practice address
30410 Highway 200
Ponderay, ID 83852-9601
Phone
(208) 263-3211
NPI assigned
Feb 2, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1271146IDMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse
Group: 193400000X SINGLE SPECIALTY GROUP
163WG0000X 1271146 ID Yes

Addresses

Primary practice location

30410 Highway 200
Ponderay, ID 83852-9601

Mailing address

26 Lula CT
Sandpoint, ID 83864-2326
Phone (208) 610-5181

Other providers in Ponderay, ID

All providers in Ponderay, ID · General Practice Registered Nurse in Idaho

Sources for this page

Verify at the official NPI Registry.