Individual
AMANDA L STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
333 N 1ST ST STE 250, BOISE, ID 83702-6132
(208) 381-9384
(208) 381-9385
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2806
ID
363A00000X
Physician Assistant
PA2465
ME
Other
Enumeration date
09/18/2020
Last updated
08/02/2024
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