Individual
ALANA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
207 1ST ST S, NAMPA, ID 83651-3703
(208) 466-7869
(208) 466-5359
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 461-7149
(208) 467-3391
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
026034
NY
363AM0700X
Medical Physician Assistant
Primary
PA-2455
ID
Other
Enumeration date
11/09/2019
Last updated
04/26/2023
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