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NPI Code Detail

MEDICARE: MICHELLE DENISE COLE-RICCARDI

MEDICARE: MICHELLE DENISE COLE-RICCARDI
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 Assistant5071591ID

General Provider Information

NPI Number : 1881359172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE DENISE COLE-RICCARDI
Provider Business Mailing Address
First Line : 190 E BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83712-6241
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 190 E BANNOCK ST
Second Line :
City : BOISE
State : ID
Zip : 83712-6241
Country : US
Telephone Number : 208-381-5500
Fax Number : 208-381-2555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2021
Last Update Date : 01/12/2026

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Directions to “ MICHELLE DENISE COLE-RICCARDI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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