Individual
DIANA GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1125 W ALAMEDA RD, POCATELLO, ID 83201-6143
(208) 739-9961
(208) 739-9961
Mailing address
125 N 8TH W, SAINT ANTHONY, ID 83445-1339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73773
ID
Other
Enumeration date
08/18/2022
Last updated
01/22/2025
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