National Provider Identifier Database

GUSTIN R BLAD, FNP-BC – NPI #1982979936
Family


Contact Information

GUSTIN R BLAD, FNP-BC
777 HOSPITAL WAY
POCATELLO, ID83201-5175
Phone: 208-239-1000
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for GUSTIN R BLAD

NPI Number 1982979936
Credentials FNP-BC (Family Nurse Practitioner)
Entity Individual
Enumeration date 03/08/2012
Last updated 03/08/2012 - About 14 years ago
Sole proprietor1 Yes
Identifiers
  • ID License #: NP-1143A
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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