Individual
MRS. MISTY M MARTINSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, MSN
Contact information
Practice address
220 BANNOCK ST, MALAD CITY, ID 83252-5068
(208) 766-2600
Mailing address
1951 BENCH RD STE B, POCATELLO, ID 83201-2073
(208) 238-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-921A
ID
Other
Enumeration date
08/24/2009
Last updated
05/22/2023
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