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Individual

CHERYL ANN CONLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2094
(208) 381-1791
Mailing address
PO BOX 1108, CORVALLIS, OR 97339-1108
(805) 286-3826

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10166960-1206
UT
363A00000X
Physician Assistant
10166960-8906
UT
363A00000X
Physician Assistant
Primary
PA-1875
ID

Other

Enumeration date
12/01/2016
Last updated
07/07/2020
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