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NPI Code Detail

MEDICARE: LINDSEY J CARMICHAEL PA-C

MEDICARE: LINDSEY J CARMICHAEL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA-944ID

General Provider Information

NPI Number : 1285904144
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY J CARMICHAEL PA-C
Provider Business Mailing Address
First Line : 190 E BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83712-6241
Country : US
Telephone Number : 208-381-8752
Fax Number :
Provider Business Practice Location Address
First Line : 2619 W FAIRVIEW AVE STE 1100
Second Line :
City : BOISE
State : ID
Zip : 83702-6722
Country : US
Telephone Number : 208-706-9300
Fax Number : 208-489-4300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2012
Last Update Date : 09/16/2024

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Directions to “ LINDSEY J CARMICHAEL PA-C” Practice Location

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