Individual
MICHAEL PAHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1550 N CRESTMONT DR, MERIDIAN, ID 83642-2184
(208) 288-4200
(208) 288-4279
Mailing address
1550 N CRESTMONT DR, MERIDIAN, ID 83642-2184
(208) 288-4200
(208) 288-4279
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
54932
ID
Other
Enumeration date
07/01/2015
Last updated
01/18/2017
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