Individual
MRS. KATIE ELIZABETH VAN LIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10255 W OVERLAND RD, BOISE, ID 83709-1430
(208) 302-5600
(208) 302-5655
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2034
ID
363A00000X
Physician Assistant
PA08089
TX
Other
Enumeration date
12/18/2012
Last updated
05/15/2023
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