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Individual

JONATHAN KEITH WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
3910 WASHINGTON PARKWAY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582
Mailing address
3910 WASHINGTON PARKWAY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-2582

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-871A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821253683
ID
Enumeration date
07/22/2008
Last updated
10/15/2021
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