Healthcare Provider Details

I. General information

NPI: 1255420550
Provider Name (Legal Business Name): SHARON J. MACNER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 N MILWAUKEE ST
BOISE ID
83704-7191
US

IV. Provider business mailing address

1740 N MILWAUKEE ST
BOISE ID
83704-7191
US

V. Phone/Fax

Practice location:
  • Phone: 208-658-0238
  • Fax: 208-658-0302
Mailing address:
  • Phone: 208-658-0238
  • Fax: 208-658-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD-5846
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: