Beverly Hanson PA

NPI 1003874389 - Physician Assistant - 363AS0400X

NPI Details
NPI 1003874389
Gender Female
Enumeration Date 05/03/2006
Last Updated 09/09/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
98 POPLAR ST
BLACKFOOT ID, 83221-1758, US
Phone (208) 782-3993
Fax (208) 782-3994
Business Location
98 POPLAR ST
BLACKFOOT ID, 83221-1758, US
Phone (208) 782-3993
Fax (208) 782-3994
Toxanomy
Taxonomy Code 363AS0400X
License State Idaho
License Number PAG-012
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According to our database, Beverly Hanson PA NPI is 1003874389, taxonomy code is 363AS0400X and license number is PAG-012, license state is located at Idaho. Beverly Hanson PA physically located at 98 Poplar St, Blackfoot ID, 83221-1758. NPI Number Beverly Hanson PA has the Individual type.

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1003874389 NPI number is provided on an as is basis without warranty of any kind. 1003874389 is maintained by the National Plan & Provider Enumeration System. The contents of Beverly Hanson PA are for informational purposes only.