Individual
MARTY J WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
700 W. IRONWOOD DRIVE, SUITE 155, COEUR D'ALENE, ID 83814-2666
(208) 667-0585
(208) 667-0876
Mailing address
700 W. IRONWOOD DRIVE, SUITE 155, COEUR D'ALENE, ID 83814-2666
(208) 667-0585
(208) 667-0876
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP911A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808374500
—
ID
Enumeration date
09/16/2007
Last updated
12/18/2013
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