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Individual

FRANNIE ANN PROFFITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1907 S BROADWAY AVE STE 101, BOISE, ID 83706-4229
(208) 345-1222
(208) 955-0494
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2094
(208) 381-1791

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1213
ID
363A00000X
Physician Assistant
PA159954
OR

Other

Enumeration date
10/15/2012
Last updated
08/14/2019
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