Blad, Gustin Ross

Blad, Gustin Ross is an sole proprietor health care provider with primary practice located at 777 Hospital Way , Pocatello ID 83201-5175. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Blad, Gustin Ross can be contacted via phone (208) 239-1000.

Contact Information

Primary practice address
777 Hospital Way Pocatello ID 83201-5175
Phone: (208) 239-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP-1143A Idaho

Profile Details

NPI number 1982979936
LBN Legal business name Blad, Gustin Ross
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 8th, 2012
Last updated Mar 8th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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