Individual
MR. MICHAEL PR BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
216 12TH AVE RD, NAMPA, ID 83686-5013
(208) 880-1928
Mailing address
216 12TH AVE RD, NAMPA, ID 83686-5013
(208) 880-1928
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
N-45980
ID
207Q00000X
Family Medicine Physician
Primary
1361873
ID
Other
Enumeration date
04/29/2024
Last updated
08/27/2024
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