Individual
MRS. AMANDA KAYE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3525 E LOUISE DR STE 195, MERIDIAN, ID 83642
(208) 846-8335
(208) 846-8336
Mailing address
3525 E LOUISE DR STE 195, MERIDIAN, ID 83642-6303
(208) 846-8335
(208) 846-8336
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
7771762-1204
UT
207RN0300X
Nephrology Physician
Primary
O-0858
ID
Other
Enumeration date
04/21/2009
Last updated
05/16/2018
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