Individual
ERIN HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 W MAIN ST STE 101, BOISE, ID 83702-7304
(208) 381-3915
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2331
ID
Other
Enumeration date
06/13/2022
Last updated
10/19/2022
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