Mason, Autumn Rose

Mason, Autumn Rose is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Mason, Autumn Rose can be contacted via phone (208) 381-2222.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-2222
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 45530 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 71748 Idaho

Profile Details

NPI number 1386305415
LBN Legal business name Mason, Autumn Rose
Credentials AGACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2021
Last updated Feb 22nd, 2022 - about 3 years ago

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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