Kalin Danial Lister, STUDENT

NPI #1033935093 in Boise, Idaho

Provider Information

NPI Number: 1033935093
Entity Type: Individual
Name: Kalin Danial Lister, STUDENT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: STUDENT
Enumeration Date: Nov 25, 2024
Last Updated: Mar 5, 2025

Practice Location

Address: 8971 W OVERLAND RD
City: Boise
State: Idaho
ZIP Code: 83709-1651
Phone: (208) 378-4288

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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