Kimberly Bousema, PA

NPI #1629819826 in Rensselaer, Indiana

Provider Information

NPI Number: 1629819826
Entity Type: Individual
Name: Kimberly Bousema, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 3, 2024
Last Updated: Mar 7, 2025

Practice Location

Address: 1103 E GRACE ST
City: Rensselaer
State: Indiana
ZIP Code: 47978-3251
Phone: (219) 866-0411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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