Individual
KATHRYN LEA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS
Contact information
Practice address
3277 E LOUISE DR, SUITE 410, MERIDIAN, ID 83642-9359
(208) 489-5800
(208) 489-4065
Mailing address
3277 E LOUISE DR, SUITE 410, MERIDIAN, ID 83642-9359
(208) 489-5800
(208) 489-4065
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TLP-011
ID
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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