Kellee J Crockett, PA-C

NPI #1952441305 in Eagle, Idaho

Provider Information

NPI Number: 1952441305
Entity Type: Individual
Name: Kellee J Crockett, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 7, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1032 S BRIDGWAY PL
Address 2: SUITE 100
City: Eagle
State: Idaho
ZIP Code: 83616
Phone: (208) 246-0123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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