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

Mark Willis, FNP

Individual provider Family Nurse Practitioner · NPI 1154838886

Mark Willis, FNP is a Nurse Practitioner in Pocatello, Idaho. Qualified in 2017, 9 years ago. Practices with Optimum Health PLLC, a 9-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2018
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1350 Cedar Lake Rd
Pocatello, ID 83204-4946
Phone: (208) 705-2575
Fax: (208) 203-1348
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 777 Hospital Way, Pocatello, ID 83201-5175 — (208) 239-1000

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 57490 (ID)

Record details

NPI number1154838886
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedJanuary 3, 2018
Last updated in NPPESMay 18, 2021
Certification dateMay 18, 2021
Mailing address1350 Cedar Lake Rd, Pocatello, ID 83204-4946

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Optimum Health Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Pocatello