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

Shannon Kay Mortensen, NP

Individual provider Nurse Practitioner · NPI 1104919695

Shannon Kay Mortensen, NP is a Nurse Practitioner in Coeur D Alene, Idaho. Qualified in 2002, 24 years ago. Practices with North Idaho Dermatology Inc, a 15-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
24
Licensed in
ID
In the registry since
2006
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

2288 Merritt Creek Loop
Coeur D Alene, ID 83814
Phone: (208) 665-7546
Fax: (208) 667-4607
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence N-31561 (ID)

Record details

NPI number1104919695
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 2, 2006
Last updated in NPPESFebruary 5, 2009

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice North Idaho Dermatology Inc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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