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Individual

DAVID WINCHESTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
2730 CHANNING WAY, IDAHO FALLS, ID 83404-5049
(208) 542-7100
(208) 542-7150
Mailing address
1274 RICHLAND DR, IDAHO FALLS, ID 83401-4088
(208) 201-3953

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
59910
ID

Other

Enumeration date
10/22/2018
Last updated
10/22/2018
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