# DARRELL A. KAMMER, A PROFESSIONAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578694923
- **Authorized official:** SUANN MCDONALD (OFFICE MANAGER)
- **Authorized official phone:** (208) 467-2129

## Contact information

- **Practice address:** 1615 12TH AVE RD, SUITE C, NAMPA, ID 83686-7713
- **Practice address phone:** (208) 467-2129
- **Practice address fax:** (208) 467-2122
- **Mailing address:** 1615 12TH AVE RD, SUITE C, NAMPA, ID 83686-7713
- **Mailing address phone:** (208) 467-2129
- **Mailing address fax:** (208) 467-2122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M-2935 | ID | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 05/12/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 290545 | BSID | ID |
| 05 | — | 804259800 | — | ID |
| 01 | — | 8K255 | BCID | ID |
| 01 | — | CK7354 | RR MEDICARE | HI |