Randall, Melisa

Randall, Melisa is an individual health care provider with primary practice located at 222 N 2Nd St Ste 204 , Boise ID 83702-6130. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Radiography, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Randall, Melisa can be contacted via phone (208) 429-9100.

Contact Information

Primary practice address
222 N 2Nd St Ste 204 Boise ID 83702-6130
Phone: (208) 429-9100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Radiography 2471C3402X 583626 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-2359 Idaho

Profile Details

NPI number 1427782549
LBN Legal business name Randall, Melisa
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2022
Last updated Oct 11th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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