Individual
LESLEY MUELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 W CHINDEN BLVD, MERIDIAN, ID 83646-6690
(208) 809-2860
(208) 809-2861
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
(208) 955-6501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2605
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
12/09/2022
Last updated
04/25/2024
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