Individual
MRS. HOLLY HAWKINS WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13176 W. PERSIMMON LANE, SUITE 100, BOISE, ID 83713-5063
(208) 377-0820
(208) 375-8046
Mailing address
6454 W. EMERALD ST, BOISE, ID 83704-8734
(208) 377-0820
(208) 375-8046
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1252
ID
Other
Enumeration date
10/11/2012
Last updated
03/20/2024
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