Individual
DR. ADAM GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-C
Contact information
Practice address
500 S 11TH AVE, POCATELLO, ID 83201-4835
(208) 232-6214
Mailing address
500 S 11TH AVE, POCATELLO, ID 83201-4835
(208) 232-6214
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
59581
ID
Other
Enumeration date
08/07/2018
Last updated
11/21/2018
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