Bosworth, Lisa A
Bosworth, Lisa A is an individual health care provider with primary practice located at 1951 Bench Rd Ste B , Pocatello ID 83201-2073. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bosworth, Lisa A can be contacted via phone (208) 238-1000.Contact Information
Primary practice address
1951 Bench Rd Ste B
Pocatello ID 83201-2073
Phone: (208) 238-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA-692 | Idaho |
Profile Details
| NPI number | 1730372756 |
|---|---|
| LBN Legal business name | Bosworth, Lisa A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2007 |
| Last updated | Feb 14th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730372756 | NPPES |
| Idaho | MEDICAID | 807835100 |
Popular Providers
-
Conner, Leslie D
651 Memorial Dr , Pocatello ID 83201-4071 -
Perkes, Charlynn S.
495 Yellowstone Ave Physicians Immediate Care Center, Pocatello ID 83201 -
Stein, Walter A
444 Hospital Way Suite 801, Pocatello ID 83201-2745 -
Lambson, Justus Flin
1595 Yellowstone Ave , Pocatello ID 83201-4203 -
Letko, Karl M
500 S 11Th Ave Suite 503, Pocatello ID 83201-4835 -
Simmons, Steven Boe
2240 E Center St , Pocatello ID 83201-2600 -
Borgholthaus, Lana
465 Memorial Dr , Pocatello ID 83201-4008 -
Bailey, Jessica
333 N 18Th Ave Suite #B, Pocatello ID 83201-3358