Individual
MS. STEPHANIE HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6140 W CURTISIAN AVE STE 200, BOISE, ID 83704-0107
(208) 302-0000
(208) 302-0055
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(082) 302-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
4883
WI
363AS0400X
Surgical Physician Assistant
Primary
PA-1408
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
N/A
—
Enumeration date
08/17/2016
Last updated
07/03/2023
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