Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariah Petersen, APP

Individual provider Primary Care Nurse Practitioner · NPI 1336938752

Mariah Petersen, APP is a Nurse Practitioner in Coeur D Alene, Idaho. Qualified in 2025, 1 year ago. Practices with Kootenai Health Inc, a 394-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
1
Licensed in
ID
In the registry since
2025

Practice location Address checks out

1919 Lincoln Way Ste 415
Coeur D Alene, ID 83814-2527
Phone: (208) 625-4595
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 — (208) 625-4595

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 8771254 (ID)

Record details

NPI number1336938752
Entity typeIndividual (Type 1)
GenderFemale
Credentials APP
Sole proprietorNo
NPI enumeratedMay 2, 2025
Last updated in NPPESMay 2, 2025
Certification dateMay 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Kootenai Health Inc — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Coeur D Alene