Individual
MONICA VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11035 KARCHER RD, NAMPA, ID 83651
(208) 302-6600
(208) 302-6655
Mailing address
910 NW 16TH ST, FRUITLAND, ID 83619-2265
(208) 302-6600
(208) 302-6655
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1412
ID
Other
Enumeration date
09/21/2016
Last updated
08/22/2020
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