Individual
SKYLER ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
2840 S MERIDIAN RD, MERIDIAN, ID 83642-7960
(208) 593-6393
(208) 593-6402
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2207
ID
Other
Enumeration date
03/16/2021
Last updated
06/04/2025
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