Individual
MARY ELISABETH TITMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3165 E GREENHURST RD, NAMPA, ID 83686-8655
(208) 463-7330
Mailing address
3165 E GREENHURST RD, NAMPA, ID 83686-8655
(208) 463-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
PA174433
OR
Other
Enumeration date
09/22/2014
Last updated
01/14/2020
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