Ainge, Charlotte S

Ainge, Charlotte S is an individual health care provider with primary practice located at 156 N. 6Th St , Potlatch ID 83855. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ainge, Charlotte S can be contacted via phone (208) 875-2380.

Contact Information

Primary practice address
156 N. 6Th St Potlatch ID 83855
Phone: (208) 875-2380
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA449 Idaho

Profile Details

NPI number 1689661050
LBN Legal business name Ainge, Charlotte S
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Apr 16th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689661050 NPPES
Idaho Other 000010149468 REGENCE BS OF ID
Idaho Other 0195084 REGENCE BS OF ID
Idaho MEDICAID 8325052 REGENCE BS OF ID
Idaho Other PAUS3 REGENCE BS OF ID
Idaho MEDICAID 806474000 REGENCE BS OF ID

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