NPI 1043286222

Mark a Granrud, PAC

Practitioner Physician Assistant Nampa, ID

Practice location

Address: 215 E Hawaii Avenue, Nampa, ID 83686
Phone: (208) 463-3000
Fax: (208) 463-3034
Mailing address: 217 W Georgia Suite 115, Nampa, ID 83686

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA621 (ID)

Other Physician Assistant providers in Idaho →

Registry record

NPI: 1043286222
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Feb 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.