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Individual

MELISSA PLAISTED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
(208) 529-7021
Mailing address
PO BOX 277381, ATLANTA, GA 30384-7381

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
58030
ID
363LF0000X
Family Nurse Practitioner
58030
ID

Other

Enumeration date
04/21/2018
Last updated
05/25/2021
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