Provider Demographics
NPI:1386233997
Name:WEST, KATHERINE LINDSEY ANN (PA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LINDSEY ANN
Last Name:WEST
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LINDSEY ANN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:388 E PARKCENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-3942
Mailing Address - Country:US
Mailing Address - Phone:208-424-9101
Mailing Address - Fax:208-424-5072
Practice Address - Street 1:388 E PARKCENTER BLVD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-3942
Practice Address - Country:US
Practice Address - Phone:208-424-9101
Practice Address - Fax:208-424-5072
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA-1968363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant