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Individual
GREGORY IMAFIDON
Active
Individual
GREGORY IMAFIDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61288019
WA
363LF0000X
Family Nurse Practitioner
AP137759
TX
363LF0000X
Family Nurse Practitioner
AP61288019
WA
363LF0000X
Family Nurse Practitioner
F04180510
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP137759
LICENSE
TX
01
—
F04180510
NP CERTIFICATION
TX
Enumeration date
05/02/2018
Last updated
11/18/2024
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