Individual ProviderAmanda BlanchetPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address190 E Bannock St, Boise, ID 83712-6241(208) 381-2222PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Blanchet is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1063997716Provider TypeIndividualFull NameBlanchet, AmandaGenderFemaleSole ProprietorNoEnumeration Date9/28/2018Last Updated6/23/2023Contact InformationPractice LocationPractice Address190 E Bannock St, Boise, ID 83712-6241Phone(208) 381-2222FaxUnlisted FaxMailing LocationMailing Address3080 E Gentry Way Ste 210, Meridian, ID 83642-3013PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA-1689IdahoCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID1152171DescriptionOtherIssuerNCCPA