Individual
SARAH CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
363A00000X
Physician Assistant
Primary
3371280
ID
Other
Enumeration date
08/08/2023
Last updated
11/10/2025
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