Individual
ELINOR GABRIELA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
388 MARTIN ST, TWIN FALLS, ID 83301-4544
(208) 737-6718
Mailing address
388 MARTIN ST, TWIN FALLS, ID 83301-4544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2367
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/03/2022
Last updated
10/04/2022
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