Individual
MRS. KATHERINE M LANSBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PA-C
Contact information
Practice address
1520 W STATE ST STE 100, BOISE, ID 83702-4084
(208) 947-7700
Mailing address
4572 S CRUZATTE LN, BOISE, ID 83716-5611
(714) 290-5841
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2088
ID
363AM0700X
Medical Physician Assistant
PA21172
CA
Other
Enumeration date
09/28/2010
Last updated
10/13/2021
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