Individual
ADAM PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1029
(208) 239-3754
Mailing address
PO BOX 4168, POCATELLO, ID 83205-4168
(208) 239-2065
(208) 239-3754
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1611A
ID
Other
Enumeration date
07/30/2015
Last updated
08/24/2015
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