Individual
MRS. TIFFANY KEARNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
900 N LIBERTY ST STE 400, BOISE, ID 83704-8707
(208) 367-7423
Mailing address
3691 N BONNIE LN, BOISE, ID 83703-4253
(208) 880-0208
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
PA-2176
ID
363A00000X
Physician Assistant
Primary
PA-2176
ID
Other
Enumeration date
12/02/2021
Last updated
10/02/2023
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