Frost, Charles

Frost, Charles is an individual health care provider with primary practice located at 4400 E Flamingo Ave , Nampa ID 83687-3402. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Frost, Charles can be contacted via phone (208) 302-7640.

Contact Information

Primary practice address
4400 E Flamingo Ave Nampa ID 83687-3402
Phone: (208) 302-7640
Fax: (208) 302-7625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA194 Idaho

Profile Details

NPI number 1760425730
LBN Legal business name Frost, Charles
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Nov 15th, 2016 - about 10 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 1760425730 NPPES
Idaho MEDICAID 804051800

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