Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WILLIAM MARK IMUS JR., FNP
ActiveNurse Practitioner · GRANGEVILLE, ID
Registration Details
- NPI Number
- 1902836802
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 4, 2006 (19.827187665878 yrs)
- Last Updated
- Jul 8, 2009
- License
-
NP57A (ID)
Practice Information
- Address
-
610 NW 2ND STGRANGEVILLE, ID, 835301244Browse ID providers · Browse ZIP 83530
- Phone
- 2089835120
- Fax
- 2089835404
- Primary Specialty
-
Nurse Practitioner
363L00000X
Other Nurse Practitioner Providers in GRANGEVILLE, ID
| Name | Credential | NPI |
|---|---|---|
| MRS. JENNIFER CARRIE LESSO | NP-C | 1225396211 |
| SUSAN CHRISTINE SMITH | RN | 1306460852 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.