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Individual

HILLARY GUTHRIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
8971 W OVERLAND RD, BOISE, ID 83709-1651
(208) 378-4288
(208) 378-4297
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6501

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2217
ID
363A00000X
Physician Assistant
PA1535
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12428227
CAQH
05
1689743700
NV
Enumeration date
11/06/2006
Last updated
02/10/2025
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