NPI 1003326398

Michael Vincen-Brown, PAC

Practitioner Physician Assistant Nampa, ID

Practice location

Address: 1115 12th Ave, Nampa, ID 83686
Phone: (208) 498-1080
Fax: (208) 498-1081
Mailing address: PO Box 191050, Boise, ID 83719-1050

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA-1538 (ID)

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Registry record

NPI: 1003326398
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Oct 2017
Record last updated: 8 Sep 2021

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.