Individual provider Active NPI

Lydia Naisiae Nkurruna

  • Registered Nurse
  • Spokane, WA
National Provider Identifier
1629667605
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
6089 Issued in WA
Practice address
5220 S Smith CT
Spokane, WA 99223-7500
Phone
(509) 329-8057
NPI assigned
Jan 13, 2021
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 6089 WA Primary

Addresses

Primary practice location

5220 S Smith CT
Spokane, WA 99223-7500

Mailing address

PO Box 30238
Spokane, WA 99223-3003
Phone (509) 329-8057

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6089WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ambassador Adult Family Home LLC CurrentSince Feb 7, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1629667605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30238",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992233003",
            "telephone_number": "509-329-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 S SMITH CT",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992237500",
            "telephone_number": "509-329-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKURRUNA",
        "first_name": "LYDIA",
        "middle_name": "NAISIAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "6089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.