Individual
AMANDA ROSE SWEETLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12273 W MCMILLAN RD, BOISE, ID 83713
(208) 367-6330
(208) 367-4765
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-6330
(208) 367-4765
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1094
ID
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
12/10/2008
Last updated
03/19/2021
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