Healthcare Provider Details

I. General information

NPI: 1306168018
Provider Name (Legal Business Name): LINDSAY ANN ERSTAD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3167 W BELLTOWER DR STE 120
MERIDIAN ID
83646-4066
US

IV. Provider business mailing address

3167 W BELLTOWER DR STE 120
MERIDIAN ID
83646-4066
US

V. Phone/Fax

Practice location:
  • Phone: 208-908-7797
  • Fax: 208-908-6588
Mailing address:
  • Phone: 208-908-7797
  • Fax: 208-908-6588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-838
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: