Individual
MS. DESIREE DARLENE REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1102 E LOCUST ST, EMMETT, ID 83617-2713
(208) 365-6004
Mailing address
1024 EAGLE HILLS WAY, EAGLE, ID 83616-5216
(208) 409-9471
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1597
ID
Other
Enumeration date
02/19/2018
Last updated
04/09/2018
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