Healthcare Provider Details

I. General information

NPI: 1306393103
Provider Name (Legal Business Name): TARAH LYNN DAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARAH LYNN ROBERTS

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 W CHERRY LN STE 204
MERIDIAN ID
83642-8530
US

IV. Provider business mailing address

PO BOX 190930
BOISE ID
83719-0930
US

V. Phone/Fax

Practice location:
  • Phone: 208-302-3300
  • Fax: 208-302-3355
Mailing address:
  • Phone: 208-367-5170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA186912
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5681501
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: