Provider Demographics
NPI:1285904144
Name:CARMICHAEL, LINDSEY J (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:J
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-381-8752
Mailing Address - Fax:
Practice Address - Street 1:2619 W FAIRVIEW AVE STE 1100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6722
Practice Address - Country:US
Practice Address - Phone:208-706-9300
Practice Address - Fax:208-489-4300
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPA-944363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical