SearchIdahoPhysician Assistant

Tate Staker, PA-C

NPI 1184253585 · on the registry since 2020 · sole proprietor

Practice

Address
130 W Main St
Rexburg, ID 83440
Phone
(208) 356-8818

Registry record

Primary taxonomy
Physician Assistant
363A00000X
Also registered as
Student in an Organized Health Care Education/Training Program
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-10-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho