TAYLOR VICKERS

NAMPA, ID
NPI1164046702
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  4161079)
Additional Taxonomies146N00000X Emergency Medical Technician, Basic
(Licence: TX  745200)
363A00000X Physician Assistant
(Licence: TX  PA13966)
363AM0700X Physician Assistant, Medical
(Licence: TX  PA13966)
Enumeration Date2020-05-29
Last Update Date2025-01-09
Business Address
TAYLOR VICKERS PA-C
9850 W ST LUKES DR
NAMPA, ID 83687-7912
Phone number: 208-205-7282
Mailing Address
TAYLOR VICKERS PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: