Individual
DR. LISA K TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
222 N 2ND ST, SUITE 215, BOISE, ID 83702-6109
(208) 381-7340
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A106188
CA
2080P0205X
Pediatric Endocrinology Physician
Primary
M-12566
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962640920
—
ID
Enumeration date
01/29/2009
Last updated
12/21/2021
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