| NPI | 1285136093 |
|---|---|
| Former Name | KELLY M LEDOUX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8503) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07941) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2025-10-03 |