Individual
WILLIAM JOHN SELF
Active
Individual
WILLIAM JOHN SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
9475918-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
9475918-4405
UT
Other
Enumeration date
08/23/2018
Last updated
01/22/2019
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