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NPI Code Detail

MEDICARE: AMELIA CRON

MEDICARE: AMELIA CRON
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 Assistant5471090ID

General Provider Information

NPI Number : 1750085023
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA CRON
Provider Business Mailing Address
First Line : PO BOX 190930
Second Line :
City : BOISE
State : ID
Zip : 83719-0930
Country : US
Telephone Number : 208-367-5170
Fax Number : 208-367-5180
Provider Business Practice Location Address
First Line : 712 AVIATION WAY
Second Line :
City : CALDWELL
State : ID
Zip : 83605-1154
Country : US
Telephone Number : 208-302-7450
Fax Number : 208-302-6625
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 02/13/2026

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Directions to “ AMELIA CRON ” Practice Location

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