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NPI Code Detail

MEDICARE: EMILY A BORDER PA-C

MEDICARE: EMILY A BORDER 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
1363A00000XPhysician AssistantPA911635FL
2363A00000XPhysician Assistant13994826-1206UT
3363A00000XPhysician Assistant3171175ID
42255A2300XAthletic Trainer757-17ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659801207
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY A BORDER PA-C
Provider Business Mailing Address
First Line : PO BOX 190930
Second Line :
City : BOISE
State : ID
Zip : 83719-0930
Country : US
Telephone Number : 208-367-5170
Fax Number : 208-367-5180
Provider Business Practice Location Address
First Line : 1510 12TH AVE RD STE 200
Second Line :
City : NAMPA
State : ID
Zip : 83686-6946
Country : US
Telephone Number : 208-302-6800
Fax Number : 208-302-6855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2017
Last Update Date : 05/22/2026

Similar Medicare Providers

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Practice Location Address:
1510 12TH AVE RD STE 200
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83686-6946
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Practice Fax:
1891264545 — TINA MONIQUE BOSSOLONO-WILLIAMS
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1548802416 — MICHAEL JEFFREY FARLEY PA-C
Practice Location Address:
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Practice Fax: 208-302-6855
1083294227 — COURTNEY SCOTT ISAACS DO
Practice Location Address:
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1083354039 — DR. JOHN KODATT MD
Practice Location Address:
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1598488959 — CHARLI MADELINE REINHART LCSW
Practice Location Address:
1510 12TH AVE RD STE 200
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Practice Fax: 208-302-6855

Directions to “ EMILY A BORDER PA-C” Practice Location

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