Individual
MISS ERIN L PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 E. ELM STE. 100, CALDWELL, ID 83605-4858
(208) 459-7415
(208) 453-3307
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 515
ID
363A00000X
Physician Assistant
Primary
PA-515
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807034000
—
ID
Enumeration date
10/27/2005
Last updated
01/10/2013
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