Individual
KELLY J BOUCHONVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-8133
(319) 356-2999
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-8133
(319) 356-4600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
124548
IA
363A00000X
Physician Assistant
14257
MN
Other
Enumeration date
03/24/2023
Last updated
08/21/2025
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