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Contact Information

MELISA RANDALL, PA
222 N 2ND ST STE 204
BOISE, ID83702-6130
 Phone: 208-429-9100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Radiography Radiologic Technologist

2471C3402X
Indicates primary specialty

NPI Profile & details for MELISA RANDALL · (Female)

NPI # 1427782549
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 07/13/2022
Last updated 10/11/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • ID License # 583626
  • ID License # PA-2359
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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