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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CHARISSE L MACK, PA

Active

CHARISSE L MACK, PA is a Physician Assistant healthcare provider located in BOISE, Idaho. NPI 1801973615 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · BOISE, ID

Registration Details

NPI Number
1801973615
Provider Type
Individual
Gender
Female
NPI Issued
Nov 1, 2006 (19.766767819582 yrs)
Last Updated
Mar 4, 2013
Licenses
PA-632 (ID)
PA632 (ID)

Practice Information

Address
6140 CURTISIAN AVE
STE 400
BOISE, ID, 837048880
Browse ID providers · Browse ZIP 83704
Phone
2083673500
Fax
2083672968
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Surgical Physician Assistant

Other Physician Assistant Providers in BOISE, ID

Name Credential NPI
MS. YELENA SHUEY PA-C 1124029939
JEFFREY D SMITH PA C 1013905793
CHADWICK ALDEN FISHER PA 1497744338
RACHEL KING PA 1205826245
DARRELL L KING PA 1770573644
THOMAS F DOUTHIT PA-C 1023008414
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.