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NPI Code Detail

MEDICARE: TANYA MARIE ALLMARAS

MEDICARE: TANYA MARIE ALLMARAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA-942ID

General Provider Information

NPI Number : 1427334929
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA MARIE ALLMARAS
Provider Business Mailing Address
First Line : PO BOX 191050
Second Line :
City : BOISE
State : ID
Zip : 83719-1050
Country : US
Telephone Number : 208-955-6500
Fax Number :
Provider Business Practice Location Address
First Line : 11197 W FAIRVIEW AVE
Second Line :
City : BOISE
State : ID
Zip : 83713-7935
Country : US
Telephone Number : 208-378-8011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2011
Last Update Date : 07/20/2021

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Directions to “ TANYA MARIE ALLMARAS ” Practice Location

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