Individual
ADAM JOSEPH THETFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5981802
ID
Other
Enumeration date
05/01/2026
Last updated
05/20/2026
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