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Individual

DEREK RICHARD WHITMILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1995 E 17TH ST, IDAHO FALLS, ID 83404-6493
(208) 357-9193
Mailing address
361 RANCH DR, IDAHO FALLS, ID 83404-7138
(208) 520-4954

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57453
ID

Other

Enumeration date
01/03/2018
Last updated
01/03/2018
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