Individual
COOPER SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
85 S MIDDLETON RD, NAMPA, ID 83651
(208) 505-2800
(208) 505-2801
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363A00000X
Physician Assistant
GPA-075
ID
363A00000X
Physician Assistant
Primary
PA-2111
ID
Other
Enumeration date
11/08/2016
Last updated
09/13/2023
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