Individual
PAUL HAISLIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
340 N 14TH AVE, POCATELLO, ID 83201-4118
(208) 241-5749
Mailing address
340 N 14TH AVE, POCATELLO, ID 83201-4118
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
58106
ID
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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