Glade Southam, NP is a family nurse practitioner in Rexburg, ID. Glade Southam, NP NPI is 1588654628. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
BYU - IDAHO
100 SHC
REXBURG, ID
ZIP 83460-010
Phone: (208) 496-1300
The enumeration date for this NPI number is 10/27/2005 and was last updated on 10/1/2007.