MICHAEL PHILIP ABRACOSA GILLIAM CPNP
Individual Provider (NPI-1)
Active
Nurse Practitioner, Pediatrics
Provider Information
- NPI Number
1487587481- Provider Type
- Individual Provider (NPI-1)
- Credentials
- CPNP
- Status
- Active
Contact & Location
- Address
- 9850 W ST LUKES DR, NAMPA, ID, 836877912
- Phone
- (208) 205-7820
- Fax
- (208) 205-7822
Specialties & Taxonomies
Nurse Practitioner, Pediatrics
Primary License: ID #5481515
All Addresses
MAILING
190 E BANNOCK ST
BOISE, ID, 837126241