Healthcare Provider Details

I. General information

NPI: 1841122298
Provider Name (Legal Business Name): ELIZABETH JOY MCKELL AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH JOY ANDERSON

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 E 17TH ST STE 170
AMMON ID
83406-6784
US

IV. Provider business mailing address

3160 E 17TH ST STE 170
AMMON ID
83406-6784
US

V. Phone/Fax

Practice location:
  • Phone: 208-944-4022
  • Fax: 208-522-5005
Mailing address:
  • Phone: 208-944-4022
  • Fax: 208-522-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number9381702
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: