Provider Demographics
NPI:1972672111
Name:MCGEE, KARA (PA-C)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 E RIVERPARK LN STE 200
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4097
Mailing Address - Country:US
Mailing Address - Phone:208-433-9300
Mailing Address - Fax:208-433-9854
Practice Address - Street 1:727 E RIVERPARK LN STE 200
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4097
Practice Address - Country:US
Practice Address - Phone:208-433-9300
Practice Address - Fax:208-433-9854
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRPA221363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDS75866Medicare UPIN