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General NPI Number Information
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NPI Number | 1346970324
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Entity Type | Individual
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Provider Name | KELSEY ANN EYOLFSON PA
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Gender | Female
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1474 N MERIDIAN RD
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City | KUNA
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State | ID
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Zip | 83634-2041
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Country | US
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Telephone | 208-809-2885
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Fax | 208-809-2886
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Provider Business Mailing Address
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Address Line | PO BOX 191050
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City | BOISE
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State | ID
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Zip | 83719-1050
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Country | US
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Telephone | 208-955-6500
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Fax | 208-955-6501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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