Individual
MS. KASSIE E ENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706
(208) 367-3131
(208) 367-3174
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 367-3131
(208) 367-3174
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MAO55875
PA
363AM0700X
Medical Physician Assistant
Primary
PA-1608
ID
Other
Enumeration date
11/27/2012
Last updated
01/24/2019
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