Individual
TAYLOR ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-S
Contact information
Practice address
6052 W STATE ST, BOISE, ID 83703-2739
(208) 344-7799
(208) 344-7152
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2740
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/01/2022
Last updated
07/20/2026
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