Individual
MR. WILLIAM LINCOLN POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
13500 SOUTH PLEASANT VALLEY ROAD, KUNA, ID 83634
(208) 371-7468
Mailing address
PO BOX 14, BOISE, ID 83707-0014
(208) 371-7468
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1187-A
ID
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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