Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KYLE HOLLENBACK
ActiveMedical Physician Assistant · MOUNTAIN HOME, ID
Registration Details
- NPI Number
- 1932574381
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 10, 2015 (10.364160901756 yrs)
- Last Updated
- Feb 19, 2020
- License
-
1330 (ID)
Practice Information
- Address
-
2280 AMERICAN LEGION BLVDMOUNTAIN HOME, ID, 836473142Browse ID providers · Browse ZIP 83647
- Phone
- 2085873988
- Fax
- 2085873324
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in MOUNTAIN HOME, ID
| Name | Credential | NPI |
|---|---|---|
| MR. DELMAR WALLACE SMITH | P.A. | 1336110980 |
| MR. DIRK KENNETH BASKETT | PA-C | 1841920220 |
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.