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1922505205
KELLY ANNE HEUSINKVELD
BOISE, ID
NPI
1922505205
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1652)
Enumeration Date
2018-04-12
Last Update Date
2019-05-01
Business Address
KELLY ANNE HEUSINKVELD PA-C
10583 W LAKE HAZEL RD
BOISE, ID 83709
Phone number: 208-302-5950
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Mailing Address
KELLY ANNE HEUSINKVELD PA-C
3340 E GOLDSTONE WAY
MERIDIAN, ID 83642
Phone number: 208-302-5950
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