Kelly Anne Heusinkveld, PA-C

NPI #1922505205 in Boise, Idaho

Provider Information

NPI Number: 1922505205
Entity Type: Individual
Name: Kelly Anne Heusinkveld, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 12, 2018
Last Updated: May 1, 2019

Practice Location

Address: 10583 W LAKE HAZEL RD
City: Boise
State: Idaho
ZIP Code: 83709
Phone: (208) 302-5950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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