Individual
MS. AMANDA C MAMRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3399 E LOUISE DR STE 400, MERIDIAN, ID 83642-5212
(208) 706-4650
(208) 706-4651
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3261975
ID
363A00000X
Physician Assistant
MA054911
PA
Other
Enumeration date
06/20/2011
Last updated
03/27/2025
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