Most Relevant Information
Provider Data
| NPI Number: | 1003326398 |
| Provider Name: | MICHAEL VINCEN-BROWN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA-1538 |
Most Important Dates
| Enumeration Date: | 10/02/2017 |
| Last Updated: | 09/08/2021 |
Provider Practice Location
1115 12TH AVE
NAMPA
ID
83686
Practice Location Phone/Fax
| Phone: | 2084981080 |
| Fax: | 2084981081 |
Provider Mailing Location
PO BOX 191050
BOISE
ID
837191050
Provider Mailing Phone/Fax
| Phone: | 2089851399 |
| Fax: | 2089856501 |