Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY MARIE LANDLE, P.A.-C
ActivePhysician Assistant · KENDRICK, ID
Registration Details
- NPI Number
- 1497723217
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 8, 2006 (20.152338257284 yrs)
- Last Updated
- Apr 16, 2019
- Licenses
-
PA-345 (ID)PA10004069 (WA)PA10004069 (WA)
Practice Information
- Address
-
606 E MAIN STKENDRICK, ID, 83537Browse ID providers · Browse ZIP 83537
- Phone
- 2082893841
- Fax
- 2082893961
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Surgical Physician Assistant
- Additional Specialty
- Medical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.