Harley Neil Sweeten | Boise, ID • PECOS Search

Harley Neil Sweeten

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

125 E Idaho St, Suite 102, Boise, ID 83712-6212

(208) 381-7300 (208) 381-2222

PECOS Enrollment

Based on the most recent information from CMS, provider Harley Neil Sweeten does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1366555971
Provider Type
Individual
Full Name
Sweeten, Harley Neil
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
8/16/2006
Last Updated
9/18/2012

Contact Information

Practice Location

125 E Idaho St, Suite 102, Boise, ID 83712-6212

(208) 381-7295

Mailing Location

190 E Bannock St, Boise, ID 83712-6241

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA326 Idaho