Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glade Southam, NP

Individual provider Family Nurse Practitioner · NPI 1588654628

Glade Southam, NP is a Family Nurse Practitioner in Rexburg, Idaho. Licensed in Idaho. Registered with an NPI since 2005.

Licensed in
ID
In the registry since
2005
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Partly verified

Some contact details are missing from the federal record.

Byu - Idaho 100 Shc
Rexburg, ID 83460-2010
Phone: (208) 496-1300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP - 747A (ID)

Record details

NPI number1588654628
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 27, 2005
Last updated in NPPESOctober 1, 2007

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