Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KIMBERLY BOUSEMA, PA
Active Sole ProprietorKIMBERLY BOUSEMA, PA is a Physician Assistant healthcare provider located in RENSSELAER, Indiana. NPI 1629819826 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · RENSSELAER, IN
Registration Details
- NPI Number
- 1629819826
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 3, 2024 (2.1841194484565 yrs)
- Last Updated
- Mar 7, 2025
- License
-
10004742A (IN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1103 E GRACE STRENSSELAER, IN, 479783251Browse IN providers · Browse ZIP 47978
- Phone
- 2198660411
- Fax
- 2198661920
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Student (Health Education/Training)
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.