person
Mark Willis, FNP
Family Nurse Practitioner in Pocatello, Idaho
NPI 1154838886

Mark Willis is a Family Nurse Practitioner based in Pocatello, ID and is specialized in Family. Mark Willis practices in Pocatello, ID and has the professional credentials of FNP. The NPI Number for Mark Willis is 1154838886 and holds a License No. 57490 (Idaho).

The current practice location address for Mark Willis is 1350 Cedar Lake Rd, Pocatello, ID and can be reached out via phone at 208-705-2575 and via fax at 208-203-1348. You can also correspond with Mark Willis through the mailing address at 1350 CEDAR LAKE RD, POCATELLO, ID - 83204-4946 (mailing address contact number: 208-705-2575).

Location: 1350 Cedar Lake Rd, Pocatello, ID, 83204-4946
person
Provider Profile Details
NPI Number
1154838886
Provider Name
Mark Willis
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
1350 Cedar Lake Rd, Pocatello, ID, 83204-4946
Phone Number
208-705-2575
Fax Number
208-203-1348
Provider Enumeration Date
01/03/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1350 Cedar Lake Rd
City
State
Zip
83204-4946
Phone Number
208-705-2575
Fax Number
208-203-1348
person
Provider Business Mailing Address Details
Address
1350 Cedar Lake Rd
City
State
Zip
83204-4946
Phone Number
208-705-2575
Fax Number
208-203-1348
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
57490 (Idaho)
Definition
Definition to come...
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