NPI 1003067984

Annie Johnson, PAC

Practitioner Medical Physician Assistant Kuna, ID

Practice location

Address: 708 E Wythe Creek CT STE 103, Kuna, ID 83634-5005
Phone: (208) 922-5130
Fax: (208) 922-5132
Mailing address: PO Box 68, Kuna, ID 83634-0068

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA-777 (ID)

Other Physician Assistant providers in Idaho →

Registry record

NPI: 1003067984
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Oct 2008
Record last updated: 1 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.