Provider Demographics
NPI:1366620825
Name:DEVLIN, KATHERINE LYNN KAISER (ARNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN KAISER
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-302-5200
Mailing Address - Fax:208-302-5225
Practice Address - Street 1:1880 W JUDITH LANE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705
Practice Address - Country:US
Practice Address - Phone:208-302-5200
Practice Address - Fax:208-302-5225
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2016-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30007931363LF0000X
IDNP-1396A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily