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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELIZABETH VICTORIA MCKENNA PA
NPI 1629807151
Physician Assistant in Boise, ID

Active since August 01, 2024
11197 W FAIRVIEW AVE, BOISE, ID 83713(208) 378-8011(208) 322-8095 Get Directions Write a Review

NPPES record last updated: October 28, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 28, 2026, Aug 1, 2024 (2 updates tracked since 2024).

About Elizabeth Victoria Mckenna Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH VICTORIA MCKENNA PA (NPI 1629807151) is an individual physician assistant in Boise, Idaho, licensed in Idaho (3381438) and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1629807151
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameELIZABETH VICTORIA MCKENNACredential: PA
Location Address11197 W FAIRVIEW AVEBoise, ID 83713-7935
Mailing AddressPo Box 191050Boise, ID 83719-1050 · (208) 955-6500 · Fax (208) 955-6501
Phone(208) 378-8011
Fax(208) 322-8095
Sole ProprietorNo
Enumeration DateAugust 1, 2024
Last NPPES UpdateOctober 28, 20262 updates tracked since enumeration
NPPES CertifiedOctober 28, 2026
✔ NPI 1629807151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · 3381438
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedEmergency Medical Technician, BasicTaxonomy 146N00000X
Also ListedNurse's AideTaxonomy 376K00000X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
11197 W FAIRVIEW AVE, Boise, ID 83713
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Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THIAGO ALBERTO NP
Nurse Practitioner
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
MRS. JENNIFER M VINCENT DO
Family Medicine
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
JORDYN JARRETT NP
Nurse Practitioner
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
ALLIANCE MEDICAL GROUP, LLC
Family Medicine
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
RYAN A MOORE MD
Family Medicine
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
TANYA MARIE ALLMARAS
Physician Assistant
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
MS. JENNA LYNN MAFFEY M.M.S; PA-C
Physician Assistant (Medical)
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011
ABBY M. LUENSMANN M.D.
Family Medicine
11197 W FAIRVIEW AVE
BOISE, ID 83713
Ada County (208) 378-8011

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elizabeth Mckenna's NPI number?

The NPI number for Elizabeth Mckenna is 1629807151. It was assigned to this individual provider in the NPPES registry on August 1, 2024.

Where is Elizabeth Mckenna located?

Elizabeth Mckenna practices at 11197 W Fairview Ave, Boise, ID 83713. The listed phone number is (208) 378-8011.

What is Elizabeth Mckenna's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Elizabeth Mckenna was last updated on October 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.