Individual
ANITA PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4424 E FLAMINGO AVE STE 300, NAMPA, ID 83687-9306
(208) 302-0200
(208) 302-0255
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2121
ID
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/25/2014
Last updated
07/22/2022
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