Kellee J Crockett, PA-C Valid NPI

Individual provider · Physician Assistant · Eagle, ID

NPI

1952441305

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

PAC636 (ID)

Sex

Female

Sole proprietor

No

Enumerated

2007-02-07

Last updated

2007-07-08