Individual
ANNALISE MABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2199 N MERRITT CREEK LOOP, COEUR D ALENE, ID 83814-4949
(208) 665-7546
(208) 667-4607
Mailing address
2199 N MERRITT CREEK LOOP, COEUR D ALENE, ID 83814-4949
(208) 665-7546
(208) 667-4607
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/22/2020
Last updated
01/11/2022
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