KELSEY WICKENHAUSER, PA

Physician Assistant

Active Individual
NPI: 1972849321

Practice Address

1368 DADRIAN PROFESSIONAL PARK
Godfrey, IL 62035

Phone: (309) 530-9841

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