Individual
ELIZABETH OLDENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10583 W LAKE HAZEL RD, BOISE, ID 83709-6326
(208) 302-5950
Mailing address
3390 E PARSNIP PEAK DR, BOISE, ID 83716-6987
(208) 860-9083
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1643
ID
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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