Individual provider · Type 1 NPI

Mark Willis, FNP

Family Nurse Practitioner · Pocatello, ID

NPI number 1154838886 Active

Practice location

1350 Cedar Lake Rd
Pocatello, ID 83204-4946

Call (208) 705-2575 Map

Fax (208) 203-1348

Other practice locations

  • 777 Hospital Way, Pocatello, ID 83201-5175 · (208) 239-1000

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X57490 (ID)

Family Nurse Practitioner: Definition to come...

2 other providers at this address

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About NPI 1154838886

Mark Willis, FNP's National Provider Identifier is 1154838886, issued on Jan 3, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Pocatello, ID. The record was last updated on May 18, 2021.