Individual
MS. TAYA D GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7272 W POTOMAC DR, BOISE, ID 83704-9149
(208) 884-2922
(208) 884-2923
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-963
ID
363AM0700X
Medical Physician Assistant
Primary
PA-963
ID
Other
Enumeration date
02/23/2012
Last updated
11/01/2023
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