Ahlstrom, Derek Scott

Ahlstrom, Derek Scott is an individual health care provider with primary practice located at 7941 W Rifleman St , Boise ID 83704-9001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Ahlstrom, Derek Scott can be contacted via phone (208) 895-7950.

Contact Information

Primary practice address
7941 W Rifleman St Boise ID 83704-9001
Phone: (208) 895-7950
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA61522965 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1715 Idaho

Profile Details

NPI number 1174096606
LBN Legal business name Ahlstrom, Derek Scott
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2019
Last updated Mar 28th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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