Individual
KATRINA MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.- C
Contact information
Practice address
3025 W CHERRY LANE, STE B, MERIDIAN, ID 83642
(208) 302-6400
(208) 302-6455
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-6400
(208) 302-6455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1427
ID
Other
Enumeration date
10/25/2016
Last updated
03/08/2017
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