NPI 1003874389

Beverly Hanson, PA

Practitioner Surgical Physician Assistant Blackfoot, ID

Practice location

Address: 98 Poplar St, Blackfoot, ID 83221-1758
Phone: (208) 782-3993
Fax: (208) 782-3994

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence PAG-012 (ID)

Other Physician Assistant providers in Idaho →

Registry record

NPI: 1003874389
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 May 2006
Record last updated: 9 Sep 2008

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.