| William Mark Imus Jr, FNP | |
|
610 Nw 2nd St, Grangeville, ID 83530-1244 | |
| (208) 983-5120 | |
| (208) 983-5404 |
| Full Name | William Mark Imus Jr |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 610 Nw 2nd St, Grangeville, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902836802 | NPI | - | NPPES |
| 804251600 | Medicaid | ID | |
| NPWD6 | Other | ID | BLUE CROSS OF IDAHO |
| 000010152061 | Other | ID | REGENCE BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | NP57A (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| William Mark Imus Jr, FNP 610 Nw 2nd St, Grangeville, ID 83530-1244 Ph: (208) 983-5120 | William Mark Imus Jr, FNP 610 Nw 2nd St, Grangeville, ID 83530-1244 Ph: (208) 983-5120 |
Ms. Katrina K Bentley, PHD, CNS, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 365 Center Road, Grangeville, ID 83530 Phone: 208-983-5535 Fax: 208-983-5575 | |
Mrs. Lynnda Lee Macmillan, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 607 W Main St, Grangeville, ID 83530 Phone: 208-983-1700 |