Individual
MIKAYLA LYNN TAUGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2365 E GALA ST STE 1, MERIDIAN, ID 83642-4881
(208) 515-2654
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
M-9901
ID
363A00000X
Physician Assistant
M-9901
ID
363AS0400X
Surgical Physician Assistant
Primary
PA-1960
ID
Other
Enumeration date
10/13/2020
Last updated
04/24/2023
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