Individual provider · Type 1 NPI

Gustin Ross Blad, FNP-BC

Family Nurse Practitioner · Pocatello, ID

NPI number 1982979936 Active

Practice location

777 Hospital Way
Pocatello, ID 83201-5175

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	NP-1143A (ID)

Family Nurse Practitioner: Definition to come...

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About NPI 1982979936

Gustin Ross Blad, FNP-BC's National Provider Identifier is 1982979936, issued on Mar 8, 2012. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Pocatello, ID. The record was last updated on Mar 8, 2012.