William Mark Imus JR., FNP
NPI #1902836802 in Grangeville, Idaho
Provider Information
- NPI Number
- 1902836802
- Entity Type
- Individual
- Name
- William Mark Imus JR., FNP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- FNP
- Enumeration Date
- Jul 4, 2006
- Last Updated
- Jul 8, 2009
Practice Location
- Address
- 610 NW 2ND ST
- City
- Grangeville
- State
- Idaho
- ZIP Code
- 83530-1244
- Phone
- (208) 983-5120
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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