Individual
NOEL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-6458
Mailing address
425 W BANNOCK ST, BOISE, ID 83702-6035
(208) 343-6458
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9109214
FL
363A00000X
Physician Assistant
Primary
PA1897
ID
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/12/2016
Last updated
07/07/2025
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