Anneke, Kathleen

Anneke, Kathleen is an individual health care provider with primary practice located at 1072 N Liberty St Ste 100 , Boise ID 83704-8708. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Anneke, Kathleen can be contacted via phone (208) 302-1200.

Contact Information

Primary practice address
1072 N Liberty St Ste 100 Boise ID 83704-8708
Phone: (208) 302-1200
Fax: (208) 302-1255
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-378 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA-378 Idaho

Profile Details

NPI number 1083837942
LBN Legal business name Anneke, Kathleen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Feb 27th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1083837942 NPPES
Idaho MEDICAID 806217300

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