Individual
MIKAYLA DAWN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
910 NW 16TH ST STE 205, FRUITLAND, ID 83619-2265
(208) 452-8100
(208) 452-8111
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
ID
Other
Enumeration date
08/03/2023
Last updated
02/06/2026
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