Gundersen, Grant

Gundersen, Grant is an individual health care provider with primary practice located at 646 W 300 S , Blackfoot ID 83221-6334. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Gundersen, Grant can be contacted via phone (208) 760-7529.

Contact Information

Primary practice address
646 W 300 S Blackfoot ID 83221-6334
Phone: (208) 760-7529
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X N-38994 Idaho

Profile Details

NPI number 1467863829
LBN Legal business name Gundersen, Grant
Credentials CNRA
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2014
Last updated May 19th, 2014 - about 10 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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