KELSEY WICKENHAUSER, PA
Physician Assistant
Active
Individual
NPI: 1972849321
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | 085 005 018 (IL) |
Frequently Asked Questions
NPI 1972849321 is the National Provider Identifier for KELSEY WICKENHAUSER, PA, a Physician Assistant provider located in Godfrey, IL. This NPI was enumerated on December 12, 2012.
KELSEY WICKENHAUSER, PA practices at 1368 DADRIAN PROFESSIONAL PARK, Godfrey, IL 62035.
Quick Facts
- NPI
- 1972849321
- Type
- Individual
- Enumerated
- Dec 12, 2012
- Last Updated
- May 13, 2014
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