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NPI Code Detail

MEDICARE: ANDI HEDGES PA-C

MEDICARE: ANDI HEDGES PA-C
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 Assistant
2363A00000XPhysician Assistant3181407ID

General Provider Information

NPI Number : 1538028733
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDI HEDGES PA-C
Provider Business Mailing Address
First Line : 10482 W CARLTON BAY DR
Second Line :
City : GARDEN CITY
State : ID
Zip : 83714-5143
Country : US
Telephone Number : 208-955-6500
Fax Number : 208-955-6501
Provider Business Practice Location Address
First Line : 6052 W STATE ST
Second Line :
City : BOISE
State : ID
Zip : 83703-2739
Country : US
Telephone Number : 208-344-7799
Fax Number : 208-344-7152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 04/06/2026

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Directions to “ ANDI HEDGES PA-C” Practice Location

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