Individual
BENJAMIN T KERNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
703 S AMERICANA BLVD, SUITE 120, BOISE, ID 83702-5099
(208) 323-2600
(208) 323-9172
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 323-2600
(208) 323-9172
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-569
ID
Other
Enumeration date
08/02/2006
Last updated
03/10/2011
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