Individual
LAUREN MEZIERE
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) 914-1695
Mailing address
2460 N PLEASANT HILL WAY, BOISE, ID 83702-5071
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
10/04/2018
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