# AUTUMN KRYSTAL VALK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356664346
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 085-003712 | IL | — |
| 363A00000X | Physician Assistant | 2541-023 | WI | — |
| 363AS0400X | Surgical Physician Assistant | 2541 | WI | Yes |

## Other

- **Enumeration date:** 03/05/2010
- **Last updated:** 04/21/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1356664346 | — | WI |