Kalin Danial Lister, STUDENT
Kalin Danial Lister, STUDENT is a Physician Assistant in Boise, Idaho. Qualified in 2024, 2 years ago. Practices with Alliance Medical Group LLC, a 130-clinician group and accepts Medicare assignment. Licensed in Idaho.
- Years since qualifying
- 2
- Licensed in
- ID
- In the registry since
- 2024
Practice location Address checks out
8971 W Overland RdBoise, ID 83709-1651
Phone: (208) 378-4288
Fax: (208) 378-4297
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 9871643 (ID) |
|---|
Record details
| NPI number | 1033935093 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | STUDENT |
| Sole proprietor | No |
| NPI enumerated | November 25, 2024 |
| Last updated in NPPES | March 5, 2025 |
| Certification date | March 5, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Group practice | Alliance Medical Group Llc — 130 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 12 on file with Medicare |
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