Organization
MAGNO C. SANTOS MSN, FNP-C PLLC
Active
Other names
SunRise Mobile Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MAGNO C SANTOS FNP-C (OWNER)
(208) 538-1963
Entity
Organization
Contact information
Practice address
2300 N YELLOWSTONE HWY # 104, IDAHO FALLS, ID 83401-1662
(208) 538-1963
(208) 615-8005
Mailing address
PO BOX 271, RUPERT, ID 83350-0271
(208) 936-8206
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IDTPID015961
—
ID
Enumeration date
10/05/2020
Last updated
12/16/2022
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