person
Nellie Lucille Boone, PA
Medical Physician Assistant in Chewelah, Washington
NPI 1134317803

Nellie Lucille Boone is a Medical Physician Assistant based in Chewelah, WA and is specialized in Medical. Nellie Lucille Boone practices in Chewelah, WA and has the professional credentials of PA. The NPI Number for Nellie Lucille Boone is 1134317803 and holds a License No. TA10005278 (Washington).

The current practice location address for Nellie Lucille Boone is 500 E Webster Ave, Chewelah, WA and can be reached out via phone at 509-935-8211 and via fax at 509-935-5257.

Location: 500 E Webster Ave, Chewelah, WA, 99109-9523
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Provider Profile Details
NPI Number
1134317803
Provider Name
Nellie Lucille Boone
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
500 E Webster Ave, Chewelah, WA, 99109-9523
Phone Number
509-935-8211
Fax Number
509-935-5257
Provider Enumeration Date
10/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00450010 01 WA RAIL ROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
500 E Webster Ave
City
State
Zip
99109-9523
Phone Number
509-935-8211
Fax Number
509-935-5257
person
Provider Business Mailing Address Details
Address
500 E Webster Ave
City
State
Zip
99109-9523
Phone Number
509-935-8211
Fax Number
509-935-5257
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
TA10005278 (Washington)
Definition
Definition to come...
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